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PBC groups urged to get radical

PBC groups need to become more ambitious, taking on commissioning for whole areas, according to a new report from an influential healthcare think tank.

PBC groups need to become more ambitious, taking on commissioning for whole areas, according to a new report from an influential healthcare think tank.

The King's Fund report urges groups to focus on the whole commissioning task to force a significant shift of care outside hospitals – not just on expanding GP diagnostic services.

Small independent GP practices operating on their own, in a jointly owned company or in co-ops were not sufficient to do this, it said.

‘It will miss the opportunity to influence where the largest areas of healthcare resources are deployed. To be effective, PBC needs to focus on the whole commissioning task.'

The report called for ‘significant scaling up and strengthening' of PBC groups, possibly through involvement with commercial firms. PCTs had limited means to support and develop groups,

it said, and were often too nervous, not impartial and took too long to make commissioning decisions.

‘To rise to the challenge of a more radical design and take on more commissioning, GPs and practices will need more support in commissioning.'

The report said commissioners were caught between managed and market healthcare systems leading to the ‘worst of both worlds'.

Having these two systems run side by side was ‘potentially disastrous' for the English healthcare system, it added.

NHS Alliance chair Dr Michael Dixon said that there was a tendency to regard PBC as the lowest form of commissioning.

‘It's a grave mistake to think of commissioning as something macho done only by managers behind closed doors who then put out to tender to be won by big companies who can loss lead.

‘Commissioning is not a beauty contest. It is about improving services and getting primary care clinicians and managers in a room with secondary care clinicians and their managers.'

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