Locality commissioning: how much influence have general practitioners really had?

This paper investigates the various models of locality commissioning in rel ation to the participation of general practitioners (GPs), and explores the perceived successes of locality commissioning in the 15 health boards in S cotland and 13 health authorities in the Northern and Yorkshire Region of E ngland. A postal questionnaire was sent to 190 individuals involved in comm issioning, and semi-structured interviews with GPs (n = 31) and health auth ority managers (n = 41) were undertaken in each of the 28 health authoritie s. Seventy-five per cent of the health authorities had introduced some form of locality commissioning. Five types of locality commissioning organizati on were identified on the basis of the level of GP influence over decisions . All GP responders identified benefits resulting from their involvement in the process but only 27% of health authority responders did so. Most benef its related to improved professional relationships, not to service changes. On the whole, locality commissioning does not appear to have resulted in m ajor changes to contracts or services.