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PCT commissioning privatised

The first private contract for commissioning support has been awarded to an accountancy firm, setting a new milestone in the increasing role of the independent sector in the NHS.

South Central strategic health authority has signed up PriceWaterhouseCoopers to provide commissioning skills for its nine PCTs, writes Helen Crump.

The firm, whose contract is worth £2m over five months, or 0.5 per cent of the commissioning budget, will be tasked with creating strategic and operating plans for each PCT, and identifying areas where capacity can be bought, built or shared.

But the SHA has assured GPs that the initiative will not clash with practice-based commissioning.

Rebecca Clegg, programme manager at South Central SHA's system reform team, said the scheme would be a 'process of engagement' between PCTs, practice-based commissioners, SHAs and PriceWaterhouse-Coopers.

She said: 'The approach we are taking is not one where the SHA and PriceWaterhouseCoopers is going to come in and say this is the right way to do it.

'The idea is that we're all working in partnership on this. We don't want to get into a situation where PriceWaterhouse-Coopers will be dictating what's right or wrong.'

She said the SHA had wanted to access 'international experience and best practice', looking to firms which had worked on commissioning in Europe and the US.

So far, PCT staff and PEC members have been invited to discuss plans, but Ms Clegg said she hoped to engage commissioning consortiums as 'key stakeholders' in the scheme.

PriceWaterhouseCoopers is also bringing its own clinical expertise, including an Oxfordshire-based GP. Dr David Jenner, commissioning lead at the NHS Alliance, said he was concerned that the move showed a lack of confidence.

'You can't do commissioning in a top-down fashion. It's frontline clinicians who actually make the decisions that commit budget,' he said. However, he admitted: 'If it's advising how to place con-tracts, specify volumes and provide expertise into a health environment, it could be useful.'

Dr Nigel Watson, chief executive of Wessex LMCs, which has LMCs in the South Central area, said he would want to know how much expertise the PriceWaterhouseCoopers team had and the cost involved.

He said: 'Commissioning has not been a success in the NHS, but I'm not sure what a bunch of accountants can offer.'

The accountants' challenge

• Create a strategic plan for each PCT to 'measure success and set long-term goals'
• Create an operating plan to develop the Local Delivery Plan year by year
• Create a people, capability and capacity plan to identify areas for improvement
• Understand the detail of the commissioning function and cycle so that the PCTs can assess their strengths and weakness and explore the benefits of working together
• Identify areas for building, buying or sharing capacity and capability from the NHS and independent sector

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