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County Durham – PBC focus waning

County Durham was originally one of the leading areas for PBC but work has been halted by PCT reconfiguration.

County Durham was originally one of the leading areas for PBC but work has been halted by PCT reconfiguration.

‘We have spent two years frustrated by poor information, business plans that don't go through and arguing over savings,' says Dr Stewart Findlay, NHS Alliance lead for PBC in the North East and a GP in Bishop Auckland.

With five PCTs merging into one, it's been an all-too-common story of disruption, with managers leaving or changing roles and unable to focus on clinical engagement.

Cost savings have been a fraught issue. ‘We have agreed with our PCT that we will have no budgets this year – we will have an incentive scheme instead.' It should mean projects won't be held up by arguments over budgets, but as Dr Findlay points out ‘it does remove the link between financial and clinical responsibility' that was intended to be at the heart of PBC.

There are, however, some signs of progress. There are six well-established PBC clusters, led by GPs who were on the professional executive committees of the old PCTs. ‘The GPs have a lot of confidence in them,' says Dr Findlay. The PCT is funding the PBC chairs for time devoted to commissioning, and PBC managers were appointed recently.

The Durham Dales cluster has put in a bid to the SHA to set up an integrated care organisation (ICO), linking GPs with County Durham and Darlington Foundation Trust. ‘There has been phenomenal interest from secondary care colleagues wanting to work with us,' says Dr Findlay. The Tees, Esk and Wear Valleys mental health foundation trust has also been supportive. ‘The chief executives see it as an opportunity to make services better for patients.'

The ICO model would involve ‘front-ending' the acute hospital with local GPs, 24 hours a day, and outpatients and minor surgery would move out to the community.

County Durham: Six well-established PBC clusters County Durham: Six well-established PBC clusters

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