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Stop playing the role of victim

Ben Gowland is frustrated at all the talk of PBC failures and says it’s time to talk up the achievements

Ben Gowland is frustrated at all the talk of PBC failures and says it's time to talk up the achievements

PBC is failing.

Or at least that's the impression you get when you listen to some of our senior policy makers. The way PBC is spoken about nationally suggests it is not succeeding – when success for PBC has never actually been defined.

PCTs might boast they have ‘100% PBC coverage' but that doesn't tell you much about the benefit to patients. Those leading PBC nationally need to articulate some hard measures of success for PBC so we know what we are being judged against.

What also annoys me is how PBC is often caught playing the role of victim. We find ourselves talking constantly about why we can't do this or why the PCT won't let us do that.

The time has come for PBC to take control of its own destiny. If PBC does not challenge the language of failure it will become a self-fulfilling prophecy. We must continue to overcome the challenges, prove ourselves and broadcast our successes.

I was struck when reading Sir John Oldham's ‘View from the top' in the January/February issue of Practical Commissioning (‘Eight keys to PBC success', practicalcommissioning.net) that very few of the eight PBC success traits he identified were factors that practice-based commissioners themselves could instil.

It was essentially a list for PCTs. So here are my eight keys to PBC success, all of which are within PBC control:

1 Make sure you have dedicated management support. Choose your own and do not accept mediocrity. If your current management support is not good enough, change it.

2 Focus initially on visible quick wins. PBC needs to make an early impact, and give itself something to build on. Use initial successes to create a language around PBC that is based on actual change.

3 Align the changes you make with the priorities for the health economy as a whole. Showing you can make a difference to the key problems of the day is critical to demonstrating the impact PBC can have.

4 Create your own measures of success. Set targets and achieve them.

5 Put as much effort into communicating successes as delivering them. Deliver first, then make sure everyone knows about it.

6 Turn the phrase ‘practice-based commissioning' into something understandable to GPs. We use ‘GP leadership of investment and change', backed up with practical examples of what we have done.

7 Agree with the PCT about the difference between practice-based commissioning and PCT commissioning, so there is a clear message for the rest of the health economy.

8 Focus on activity data to begin with and the financials will nearly always follow. Your GP colleagues understand and can influence activity data. The PCT is much more likely to be able to provide relevant activity data than finance data.

There seems to be a deep-seated belief that somehow making PBC ‘succeed' is a PCT responsibility. It is not. Only practice-based commissioners can make PBC work.

Ben Gowland is chief executive of Nene Commissioning Community Interest Company, the largest PBC consortium in the country and winner of the NAPC's award for Most Advanced PBC Consortium in 2008

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