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Darzi review will bring new PBC incentives for GPs

By Gareth Iacobucci

Lord Darzi's much-anticipated review of the NHS will ‘reinvigorate' practice-based commissioning by focusing on transforming data quality and strengthening incentives for GPs, a key advisor has told Pulse.

His comments came as a new report by a former head of Government health strategy called for GPs to be handed real budgets, as part of a ‘radical expansion' of PBC.

The report for the Nuffield Trust claimed PBC had so far acted as a barrier to providing secondary care services in the community, and said a major overhaul was needed in order to achieve the Government's aims.

Professor Chris Ham, report author and professor of health policy and management at the University of Birmingham, said the problems could be overcome if GPs were given full control over their budgets and incentives to commission .

Professor Ham, who led the Department of Health strategy unit until 2004, added that there was a need for ‘stronger incentives to support clinical integration, through a radical expansion of practice-based commissioning'.

Details of the report came as Dr Michael Dixon, a leading primary care advisor to Lord Darzi, told Pulse the health minister would be addressing weaknesses in PBC in his upcoming review.

Dr Dixon, chair of the NHS Alliance and a GP in Cullompton, Devon, said he expected the review to focus on proposals put forward in the Alliance's recent document ‘In Sickness and In Health'.

The report called for PBC to be strengthened by the provision of ‘essential data and management information' that was ‘accurate and provided in real time', and for new Innovation Funds to be set up to spur local commissioners.

Dr Dixon said: ‘The Department of Health's world class commissioning initiative is totally dependent on PBC as far as I'm concerned. If we don't get PBC right, none of it will be right.

‘Expect the Darzi review to say that PBC is something that really does need reinvigoration, and does need to be thoroughly supported.'

The Nuffield Trust report - entitled Integrating NHS Care: Lessons from the Frontline – called for Lord Darzi to address key weaknesses in PBC, with Professor Ham warning it had failed to take off ‘to the extent that politicians had hoped'.

Professor Ham said: ‘What I would hope to see in the Darzi review is a much more radical version of what we call PBC. One that gives GPs more opportunity to control budgets. ‘We need to give practices real responsibility for deficits, and for PCTs not to constrain the best practices.'

Lord Darzi: plans to salvage practice based commissioning Lord Darzi: plans to salvage practice based commissioning

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