The Health and Social Care Act 2012 outlined the new structure of the NHS with the abolition of PCTs and SHAs and the establishment in 2013 of Clinical Commissioning Groups accountable to the NHS Commissioning Board (NHS England) which also has responsibility for commissioning all primary care services, including general practice. Under the Act it is the NHS Commissioning Board (NHS England) which formally recognises the LMC as the local representative body. However in April 2015 NHS England gave delegated responsibility for commissioning general practice in Birmingham to the city’s three CCGs through the co-commissioning arrangements. This means that the CCGs too now have a delegated statutory duty to recognise the LMC as the formal representative body for all their member GPs. NHS England however retains responsibility for all issues concerning professional performance and the GP performers list, including responsibility for GP appraisals and recommendations for revalidation.
NHS England’s responsibilities have been further delegated through the rationalisation and privatisation of all their primary care support services (formerly Family Health Service functions) to Capita, with the loss of the local primary care support office and staff.