To what extent could local general practitioners commissioning help increase the effectiveness of NHS at primary care? A meta-ethnographic study in the UK

The UK coalition government's recent White Paper 2010 places GPs at the centre of the commissioning process through the establishment of GP consortia by April 2010 (DH, 2010a, 2010b) where GP consortia will be responsible for commissioning primary care services. In the past, the commissioning authorities and responsibilities were given to the PCTs (DH, 2010c). It has been noted that under these reforms public health responsibilities will be divided between local authorities and the new national public health service (DH, 2010a,b,c). It is claimed that local GP commissioning will bring high-quality and cost-effective care to local communities by 'patient empowerment, local professional judgement and greater provider dynamisms' (Steven, 2010, p.231). Making "... services more directly accountable to patients and communities" is the key aim of the NHS reform (Great Britain. Parliament. House of Common, 2011, p.x). But is that often the case? This paper will attempt to further discuss this question.