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At the heart of general practice since 1960

Moving from supporter to player

Dr Peter Devlin on how GPs in Brighton feel a real part of the local health economy – rather than onlookers in the stands

Dr Peter Devlin on how GPs in Brighton feel a real part of the local health economy – rather than onlookers in the stands

At this month's Practical Commissioning seminar in London, Dr Nick Goodwin, senior fellow at the King's Fund, spoke of the Department of Health often quoting its own surveys as showing support for PBC as being about a constant 65%. But he then went on to point out there was quite a difference to being a supporter at a football match and being an actual player.

His observation chimed with what our own PBC journey has been like in Brighton. I am pleased to say we are now midfield but it has been a tortuous and a bumpy journey.

We now feel here in Brighton that we are on course to deliver a clinically led NHS in which primary care can be at the centre of excellence in commissioning and innovation in service provision

Central to the change was formation of the Brighton Integrated Care Service, a not-for-profit umbrella organisation that has been able to support the local PBC groups and also controls a gateway service triaging some 40,000 elective care referrals a year.

When we formed BICS 18 months ago, and sought the active support of a critical mass of local practices, we were always clear that gateway management would provide us with the demand data we needed to begin to unlock the PBC impasse. BICS has given PBC clinicians the support they need to begin to be effective commissioners.

For a future in which our PCT is charged as a World Class Commissioner to ‘stimulate the market', we also went out to colleagues with a more subtle message about the need for practices to approach this future in a spirit of collaboration, and to adopt our own version of the RCGP's federal model.

Many GPs in Brighton and Hove were quick to recognise the potential benefits of using BICS to provide them with the support they need to develop their ambitions as providers of extended primary and community services.

As the PCT has matured in its understanding of what has been described as the ‘sophisticated interplay' between commissioning and provision that is integral to primary care, so has grown its willingness to embrace BICS as a key enabler of the local primary care market. We have been able to help senior managers in the PCT to stop seeing PBC as a problem, and to come to see primary care clinicians as part of the solution to delivering their vision.

So we are now in a position to help one local practice to utilise the specialist skills of one of its GPs and deliver its long-held aspiration to provide a minor eye clinic for patients from across the city. We are working on a similar project with another practice for minor ENT problems.

We are engaged in an ambitious plan to transform the provision of musculo-skeletal services in partnership with the acute trust and community services.

Brighton and Hove has long been held back by what others have seen as a lack of interest in developing a GPSI workforce. Last week BICS wrote to all local GPs to measure interest in working in musculo-skeletal care. Within three days we had a list of 15 colleagues, one with a masters in sports medicine, another with years of experience working as a staff grade in orthopaedics.

It's a beautiful game if you find a way to move on to the pitch and get into the team.

Dr Peter Devlin is a GP in Brighton and clinical director of BICS

Dr Peter Devlin (front), a GP in Brighton and clinical director of BICS

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