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GP consortia hamstrung by patchy progress on PCT clusters

By Alisdair Stirling

Exclusive: Many PCTs have yet to thrash out the details of how they will form clusters with neighbouring trusts, leaving GP consortia unsure which combinations of PCTs they will be dealing with, a Pulse investigation reveals.

It comes as Sir David Nicholson, the new head of the NHS Commissioning Board, told a summit of the first pathfinder consortia last week that PCT clusters will be ‘critical' to the success of GP commissioning.

Sir David said that the formation of PCT clusters would help simplify matters organisationally for consortia and help cut PCT management costs.

He stressed the clusters were only a temporary measure - time limited to two years - and only intended as a resource not a means of control.

But his comments came as a Pulse investigation found progress towards forming the clusters is patchy across England. Half of the 66 PCTs surveyed by Pulse have yet to decide even which PCTs they will be clustering with. NHS South West and NHS Yorkshire and Humber said none of the 26 PCTs in their area had yet decided how clusters would work locally.

In other parts of the country, clusters have already formed although joint financial plans for dealing with savings have yet to be thrashed out.

In London, PCTs are grouping themselves into six ‘sectors' which equate to PCT clusters. A spokesman for the NHS North West London cluster said eight PCTs there had grouped together under a single executive management team in a bid to slash management costs by two thirds and corporate costs by half.

Elsewhere, NHS Birmingham East and North is already in a cluster with Heart of Birmingham teaching Primary Care Trust, NHS South Birmingham and Solihull Care Trust, while NHS Stoke on Trent plans to cluster with NHS North Staffordshire and South Staffordshire PCT.

The NHS Operating Framework for 2011/12 sets a deadline for the formation of clusters of the beginning of June. Dr Mike Bewick, medical director of NHS Cumbria and a GP involved with setting up a first wave pathfinder consortium in Cumbria, said he welcomed the formation of clusters ‘as long as there's a logic around understanding what the consortia are trying to do.'

‘There is a potential to choose your cluster but consortia want to deal with a cluster that will understand their aims and aspirations. Essentially people are going to lose their jobs but we should end up with a highly motivated team.'

Dr Mike Bewick and one of the GPs in his area, Dr John Howarth What does the health bill mean for GPs?

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