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Gold, incentives and meh

PCTs given two years to deliver

Practice-based commissioning is running out of time to 'prove itself', a leading advocate of the scheme has warned.

Speaking at the NHS Alliance's spring conference last week, Dr Mike Dixon, chair of the alliance, warned PBC had just two years to win over GPs, PCTs and politicians, and must start delivering real benefits in terms of services and savings.

'If within two years it's failed to do that, with elections looming, people will be saying PBC can't hack it,' he said. 'People won't take any more excuses.'

The stark warning follows similar comments from another key supporter of PBC. Earlier this month, Dr James Kingsland, chair of the National Association of Primary Care, told Pulse: 'There's a feeling that we have got a matter of weeks left.'

Dr Dixon said that while more practical support was needed from PCTs, and more public support from the Government, it was up to GPs themselves to take the initiative.

'I think for GPs the message is hit the ground running now,' he said. 'We have a unique opportunity to expand what we're doing in general practice, but it's an opportunity that is here today and will be gone tomorrow.'He also called for the Government to publicly state its commitment to PBC.

While health secretary Patricia Hewitt was on hand to pledge her support, she is widely tipped to lose her job in a summer Cabinet reshuffle.'We need a strong message from Gordon Brown when he takes over that this is here to stay,' said Dr Dixon.

Dr Richard Lewis, a King's Fund fellow currently on secondment to the Prime Minister's Delivery Unit, said that simple steps would help get PBC back on track.'

The solution to implementation is staring us in the face: agreeing budgets, getting information right, support for PBC with protected time, people and money, and a good package of incentives,' he said.

'It's not all doom and gloom, but PCTs are not generally providing enough support for PBC.'

Dr Mark Sweeney, chair of the Kensington and Chelsea PBC group, said GPs were frustrated by practical problems with commissioning, such as the lack of data available.

'While we would very much like to take PBC forward, in its current form it's not fit for purpose,' he said.

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