Efforts to involve locum and salaried doctors in the development of clinical commissioning groups have failed, a new survey has found.

Findings from a recent Royal College of General Practitioners poll showed that just 7% of sessional GPs felt that their commissioning group respected them and their contracted partners equally.

Dr Su Stone, clinical lead for the RCGP Sessional GPs in Commissioning Project, said the survey had found a “massive disparity” around the involvement of locum GPs across the country.

Results showed that nearly all CCGs (95%) said they allowed GP partners to vote in important elections. However, just two-thirds of locum or salaried GPs said they were permitted to participate in similar votes.

Nearly half (48%) of the CCGs which responded to the survey said they regularly communicated with sessional doctors. Yet only 37% of locums believed they were kept informed of important issues.

Dr Richard Fieldhouse, Chief Executive of the National Association of Sessional GPs, said the results were disappointing but he was not surprised at them. He added that sessional doctors should be included in the development of CCGs due to their lack of conflicts of interest and experience of working across multiple practices.

The poll received responses from around half of the 212 CCGs across England and 620 (5%) of locum and salaried GPs.

Patients in East Lancashire can expect to see local health services dramatically improve within the next couple of years, a new CCG head has predicted.

Dr Mike Ions (pictured), who was recently elected to lead the new NHS East Lancashire Clinical Commissioning Group, wants to improve services for residents but warned there was no quick fix.

Dr Ions admitted that patients won’t “notice a difference at first” but said “over two or three years we hope there will be a big improvement”.

As part of the measures to the quality of care residents receive, the CCG will commission health services closer to their homes under new powers included in the Health and Social Care Act.

“We want fewer people travelling outside the area or to large district hospitals,” said Dr Ions.

“To achieve this, for example, the CCG is now working with the hospital trust to develop tele-healthcare, where patients with respiratory problems can do their own routine health diagnostic tests at home and send the results to the hospital via telephone or secure internet.

“GPs are much more in tune with patients’ wishes and are better at getting general feedback – PCTs can seem very remote.”

The Government’s controversial reforms to the NHS have been widely criticised. However, Dr Ions said attitudes in the region have been far more positive.

“All 65 surgeries in East Lancashire have signed up to become members of the CCG and the doctors I speak to are embracing the change,” he said.

“We want to be responsive to the individual needs of the patient, and there will be differences in services in areas depending on the population’s need, though the delivery of core services will be the same nationally.”

NHS East Lancashire Clinical Commissioning Group will be one of the largest commissioning bodies across England – serving 370,000 patients. It will have a budget of around £450m each year.

Representatives of the DH and the NHS Confederation have disagreed over the importance of NICE guidance.

A trust survey by GP magazine that showed ‘non-urgent’ operations are being rationed by most trusts triggered a variety of official responses.

The survey found that 90% of trusts were rationing tonsillectomies, two-thirds were rationing cataract surgery, and more than half were rationing weight loss surgery and hip and knee operations.

These findings are similar to ones published a year before – but in the meantime, public concern over the impact of NHS spending cuts has deepened.

The BMA’s Dr Richard Vautrey said: “We’re supposed to have a national health service, so there should be national consistency in service availability.”

Health Minister Simon Burns called rationing “unacceptable” and promised: “If local health bodies stop patients from having treatments on the basis of cost alone, we will take action against them.”

His comments echo recent Government pledges to ensure that NICE guidelines are more closely followed.

However, David Stout (pictured), Deputy Chief Executive of the NHS Confederation, justified rationing by trusts: “The NHS faces considerable financial pressures and scarce resources have to be used as effectively as possible.”

NICE guidelines were “just advice”, he argued, and trusts should not try to follow them closely – though national consistency would have “some advantages”.

NHS investment in treating mental illness could save far more money spent on treating linked physical illness, according to the London School of Economics.

The report How Mental Illness Loses Out In the NHS says the NHS spends at least £10bn per year in treating physical illnesses that could be prevented by low-cost psychological therapies.

The LSE’s Mental Health Policy Group concludes that under-treatment of severe mental illness is “the most glaring example of health inequality” in the UK.

A 2007 survey showed that only 24% of people with depression and anxiety disorders were receiving treatment – and only 2% were receiving CBT, the main NICE-recommended treatment.

The report places more emphasis on CBT and related therapies than on drugs, because they are cheaper and have been shown to achieve similar (but more lasting) outcomes.

Drawing on evidence that CBT is cost-effective in managing long-term physical conditions such as COPD and heart disease, the report argues that psychological therapies need to play a stronger role in general healthcare.

It recommends integration of this perspective into the NHS Outcomes Framework, as well as expansion of the existing NHS Improved Access to Psychological Therapy programme.

The BMA commented that it was “concerned about the poor physical health and early death of many with serious mental health problems” and viewed the report as an “excellent starting point” for work to address that “major inequity”.