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Hewitt criticises PCTs over commissioning

PCTs must make it an 'absolute priority' to get behind practice-based commissioning, Health Secretary Patricia Hewitt has urged.

But senior Department of Health officials ruled out introducing national targets or renewing the PBC directed enhanced service.

Speaking at the NHS Alliance spring conference last week, Mrs Hewitt said PBC was 'at the heart of a patient-led NHS', but admitted GPs were not getting the support they needed to make it happen.

'We can see very rapidly the infrastructure for PBC is being built,' she said.

'This is already starting to work. But there is frustration. I hear from so many of you that it is not going fast enough.'

A joint NHS Alliance-King's Fund survey, published in advance of the conference, found GPs were facing a number of obstacles to PBC.

More than a third (39%) of the 250 GPs and practice managers surveyed blamed a lack of PCT support, while nearly a quarter (23%) said financial constraints and short-term thinking were significant obstacles.

Mrs Hewitt called for PCTs to take immediate action to ensure GPs were provided with proper support, including adequate information and indicative budgets: '70% of you haven't got agreements with PCTs on budgets,' she said. 'That is simply not good enough.'

However, Gary Belfield, director of programmes in the department commissioning directorate, said there were no plans to introduce national targets.

'We need to give PCTs time; let's just hang in there,' he said.

The one-year 'towards practice-based commissioning' DES expired at the end of March, and some delegates at the conference called for it to be renewed to win over GPs with doubts about PBC. 'At least that gave us an incentive,' said Dr Adam Grieg, a GP in Berkshire.

But Dr Barbara Hakin, chief executive of NHS East Midlands and chief negotiator on the GMS contract for NHS Employers, said it was unlikely to be renewed.'

The DES was too much of a straitjacket,' she said. 'People wanted to be left to make their own arrangements.'

Hewitt on PBC

• 'The absolute priority for PCTs over the next few months and less is to get behind practice-based commissioning.'

• 'We're at a tipping point – all the enthusiasm needs to be translated into action.'

• 'There is frustration from so many of you that it is not going fast enough, that you're not getting the support you need to make this happen.'

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