GPs face new hospital admission targets
By Gareth Iacobucci
GPs are to be set targets for keeping patients out of hospital as part of a Government drive to improve PCT commissioning.
Ministers are also intent on involving the private sector in how to spend NHS cash, with details emerging of the first commissioning contract to be handed to a private firm.
PCTs will be told to tap into the private sector to tackle a list of up 15 health priorities from a new outcomes and accountability framework.
These will help PCTs measure primary care services in a list of areas such as reducing emergency hospital admissions for chronic conditions, obesity and mortality rates.
The Department of Health warned that if the targets – set to be unveiled this week – were not met by existing providers, PCTs could turn to the private sector instead.
The move has re-opened fears over the powerful role of the private sector under the Government's Framework for procuring External Support for Commissioners (FESC).
Pulse has learnt that BUPA, one of 14 companies on the approved FESC list, has signed a provisional contract with cash-strapped Hillingdon PCT, with the Government set to rubber-stamp the three-year deal by the end of next month.
The final deal had been held up over concerns about its cost-effectiveness.
The department confirmed a further six areas were being lined up for further pilots. Pulse understands up to 80 PCTs are being earmarked to receive support from a list of companies also including the likes of Dr Foster Intelligence, AXA PPP Healthcare and Aetna Health Services.
The Government plans to use FESC to help enforce its new World Class Commission-ing goals, warning: ‘If existing providers are unable to meet the desired standards, PCTs may turn to new providers to meet the service specifications and standards they expect.'
Dr Richard Vautrey, GPC vice-chair, said there were major fears over potential conflicts of interest, despite the Government vowing FESC commissioners would be kept away from areas in which they also provided services. ‘It's important companies are very open to scrutiny,' he said.
But Dr Natalie-Jane Macdonald, BUPA's medical director, said conflicts of interest were ‘everywhere', and ‘not in any way limited to those with FESC contracts.' She said BUPA's remit was to help PCTs manage its commissioning relationships, and stressed the company did not run services in the area.DH Dr Sabby Kant: anxiety about where private sector involvement will lead Dr Sabby Kant: anxiety about where private sector involvement will lead Where will it all lead? Where will it all lead?
Dr Sabby Kant (pictured), a GP in Northwood, Hillingdon - where a firm is to aid PCT commissioning for the first time - said GPs have a 'psychological anxiety about where the plans could lead'.
He said: 'In principal, there's nothing wrong with a company helping to improve the efficiency of a PCT. But - and I'm not speaking about this example - sometimes one does wonder about the real remit of these companies.
'If they want to get themselves in the position of competition, one of thei strategies might be to convertly get involved in projects that give them the know-how.'