Missing indicative budgets prompt calls for new rules
Concern over the number of PCTs due to miss the 1 May deadline for provision of indicative budgets has prompted calls for tough regulations to replace the Government’s softer ‘guidance and entitlements’ approach.
Concern over the number of PCTs due to miss the 1 May deadline for provision of indicative budgets has prompted calls for tough regulations to replace the Government's softer ‘guidance and entitlements' approach.
It follows the publication last month of Clinical Commissioning: our vision for PBC, which said practices should receive their indicative budgets by 1 May, with recourse to the SHA if PCTs failed to deliver.
But the latest Department of Health survey out last month showed the number of practices with an indicative budget had fallen to 69%, compared with 72% in the December survey.
Independent PBC consultant Scott McKenzie, who works with 20 PBC consortiums, told Practical Commissioning: ‘Most PBC groups view the deadline of 1 May with a great degree of scepticism.'
Dr James Kingsland, NAPC president and a member of the DH's PBC improvement team that is currently visiting all SHAs, called for more formal investigation if areas failed to meet the deadline.
He added: ‘My feeling is that if the PBC guidance is not being acknowledged or indeed is being ignored then we've got to have some measures that move us from guidance to directives.
‘We're at the tipping point of reinvigoration. If we don't see a significant leap forward soon then the next stage must be to have some more formal rules and regulations guiding PBC.
‘We're now into year five of PBC implementation and can't afford to have any further stalling.'
Mr McKenzie said he agreed that regulations were now needed.
‘I think it's much easier if you make it hard and fast. PCTs say to me that what the Government wants people to deliver is only guidance. I would much rather it was black and white.
‘The Government never likes to set rules. But would Coca Cola give every retailer the chance to do their own thing? Never. With the current PBC guidance you get 152 variations on the same theme.'
Dr Mike Dixon, NHS Alliance chair, said that although he was not in favour of formal regulations, one or two clear central indicators could make a difference to PBC.
‘You could say what should be the minimum management allowance for a PBC group and an overall costing towards PBC so at least there is a benchmark.'
Dr Dixon said he thought there would still be ‘quite a few' practices without an indicative budget on 1 May.