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PBC still failing to stir GPs

26th June 2006

26062006_FedUp1.jpgGP leaders, the government and primary care trusts have all ‘failed to inspire’ doctors to take up practice-based commissioning, according to an NHS Alliance report.

The report, based on workshops with over 2,000 members, says the biggest problem has been the ‘lack of clear communication and leadership’ from the centre, strategic health authorities and PCTs. It said frontline staff were confused about government policy on PBC and where it fits into the overall policy picture.

NHS Alliance chair Dr Michael Dixon said around one in five PCTs were understood to have signed up to PBC, ahead of the government’s end-of-year deadline.

Meanwhile, the restructuring of PCTs and efforts to claw back deficits meant they were unable to ‘commit the necessary resources to the implementation of PBC’. A majority of practices taking part in the workshops said they were still waiting for their indicative budgets.

The workshops revealed that information and data from PCTs on PBC is ‘typically poor, in the wrong format or does not exist’.

Dr Dixon said there was still a ‘hearts and minds issue’ about PBC engagement. He said many clinical staff ‘knew the government wanted them to do it and knew it was about saving money’ but had not been persuaded of the ‘enormous opportunity to make a big difference to services locally’.

Delegates predicted that PBC would lead to a more a more ‘adversarial’ relationship between commissioners and hospitals, hindering the development of clinical pathways.

The report concluded that even though delegates felt ‘frustrated and sceptical’ about PBC at the beginning of each workshop, enthusiasm grew when they realised how information on hospital activity and financial data could stimulate service redesign.

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