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GPs blame managers for PBC failings

Most GPs believe practice-based commissioning has so far failed to make any impact on patient care, a Department of Health survey reveals.

The survey of 1,198 practices found that 31 per cent of GPs believed practice-based commissioning had improved care, while only 13 per cent said that it had. Some 37 per cent said it was too early to tell.

While GPs were generally supportive of the policy of practice-based commissioning, they were scathing of its implementation by PCTs.

More than half of practices rated the quality of managerial support provided by their PCT as poor, with 26 percent assessing it as very poor. Fewer than half of practices had agreed a commissioning plan.

The majority of practices support PBC as a policy: 57 percent of GPs said they are supportive, whilst a further 22 percent were neutral. Only eight percent strongly oppose the policy.

Dr James Kingsland, chair of the National Association of Primary Care and a member of Lord Ara Darzi's new NHS review panel, said the survey was an ‘indictment' of PCTs' handling of PBC and warned the lack of support from PCTs risked eroding GP backing for the scheme.

‘There is still an appetite for PBC, but there is scepticism growing from the practices that haven't been given proper data, budgets or support.'

Dr Kingsland said PCTs needed to show greater leadership to ensure the scheme's success, pointing to the number of business plans developed by GPs that were rejected by PCTs.

‘They shouldn't be vetoing – they should be welcoming and applauding the fact a group of clinicians have designed something they think is what their patients need,' he said.

More than half of practices had some or all of their business plans for a service redesign rejected, according to the MORI poll. The poll follows a Pulse survey in August, carried out by Pearl Medical, which showed nearly half of GPs had seen their appetite for PBC diminish.

But Dr Mike Dixon, chair of the NHS Alliance and commissioning lead on Lord Darzi's panel, said that although improvements needed to be made in PBC, the culture in PCTs and GP surgeries was changing. ‘PCTs and GPs are getting the message that it is here to stay and that their mutual future depends on getting it right.'

Other findings included:

60% of practices had commissioned no new services through PBC.

21% were providing more services through PBC

56% of practices had received an indicative budget from their PCT, but 74% believed it had made little or no difference to the way their practice operated.

59% of GPs were not confident their commissioning plan would free up resources.

Only a third of practices rated the quality, format and frequency of information provided by their PCT as being good.

72 percent of practices said they had a good relationship with their PCT.

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