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Patient care 'not improved by PBC'

More than half of GPs believe practice-based commissioning has failed to improve the quality of patient care.

The damning verdict came from 53% of the 250 GPs and practice managers surveyed by the NHS Alliance and the King's Fund. But in spite of this, 73% of respondents were committed to taking part in PBC. More than a third (39%) cited a lack of PCT support as a barrier to success and nearly a quarter (23%) felt financial constraints and short-term thinking were significant obstacles. Dr Richard Lewis, senior fellow in health policy at the King's Fund, said: 'The reality is that many PCTs see practice-based commissioning as something that needs to be done alongside many other targets.'The findings came as the alliance called for common sense in setting up commissioner/ provider relationships.Using the example of a hospital that increased its income by 40% in the first year of payment by results, throwing PCTs into severe financial difficulty, alliance vice-chair Dr Donal Hynes said a mixture of competition and co-operation was needed to make the system work.The comments came a week after the BMA called for a more mature approach to commissioning, diminishing the need for a purchaser/provider split.

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