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At the heart of general practice since 1960

I wish he’d said this…

Editor Sue McNulty makes the case for local produce

Editor Sue McNulty makes the case for local produce

At the recent NAPC annual conference there was a big breath of fresh air blowing in one of the sessions.

Even through my sleep deprived, caffeine high, I clearly heard Andrew Donald, chief operating officer from Birmingham East and North declare "we got it wrong" on PBC.

This admission was despite their world class commissioning assurances making them look good on PBC. They could have kept quiet but they actually listened to what GPs on the ground were saying and have set about to change things.

This is fab, I thought. How often do you hear a PCT person say " We got it wrong" on PBC? Tell me more.

"We devolved responsibilities but discovered we retained full control" he continued.

"I'm often asked what good commissioning looks like – I say it comes from excellent provision".

The man has seen the light, I thought. He wants GPs to form themselves into the best provider organisations ever and deliver care to serve patients based on their unique insight they have into the local population and the problems with current service provision.

So impressed was I that I doorstepped Mr Donald after his presentation and asked him to write 500 words for the December edition of Practical Commissioning.

But when his copy came in I realised I'd misunderstood. The provision he was referring to was primary care - the GP's day job.

Andrew was saying that if you get primary care absolutely right, with perfect demand management and use of services appropriately this in itself would save hundreds of thousands of pounds. Birmingham East and North has therefore stopped talking about freed up resources and instead set up a alternative PBC scheme where GPs receive a reward payment for achieving certain objectives.

I'm not saying this scheme isn't worthwhile – I just wish he'd said what I thought he had. That GPs should provide everything they want to if they're up to the job of doing so.

With the recent news about hospitals being named and shamed for having filthy wards and dangerous care - the same hospitals that had glowing Care Quality Commission reports - I think the case becomes even greater for GPs to be providers.

Hospitals are just too big. And having clinicians involved in the management – as well as the commissioning - of care has to be the way forward. Those who want ownership – literally – should be allowed to have it. In fact I would go even further and say it should be actively encouraged with the creation of a PBC enterprise support programme. GPs are already a nation of shopkeepers. They proved what they can do with out of hours co-operatives. Let's get rid of the hospital ‘Bluewater' shopping centres and return to local produce!

Practical Commissioning editor Sue McNulty Editor Sue McNulty

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