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Independents' Day

PCTs 'worst performers in the NHS'

PCTs are the worst performing part of the NHS for the second year running, new inspection data from the Healthcare Commission shows.

Ten PCTs were rated weak for both quality of services and use of resources - and not a single trust was rated excellent in both categories in the annual health checks.

Recently reconfigured PCTs were among the poorest performers, with nine of the 10 that scored a double 'weak' having been reorganised in the 2006/7 assessment year.


Three-quarters of PCTs were rated only fair or weak for quality of services and just two trusts - Birmingham East and North and South Tyneside - were graded excellent.

Five for the top rating for use of resources.

This was in sharp contrast to mental health trusts, the best performing sector, where more than half got an excellent rating for quality of services.

David Stout, Director of the Primary Care Trust Network, said further upheaval to PCTs' governance arrangements would be ‘disastrous' for patients.

‘We must avoid knee-jerk reactions which call for unnecessary restructuring, and allow PCT managers to focus on delivering the best quality patient services,' he said.

The commission highlighted trust's shortcomings in updating practice-based CHD and diabetes registers, with more than half failing to reach this target. It blamed PCTs' poor performance in this area partly on the fact some registers were excluded from the QOF.

Dr John Ashcroft, a GP in Ilkeston, Derbyshire and member of the local CHD strategic group, called for CHD risk assessment registers to be included in the QOF.

‘PCTs are failing to fulfil the NICE guidance due to an absolute obsession GPs will waste vast amounts of money,' he said.

The commission report said practice-based registers were an ‘effective means of managing and preventing disease'.

But it warned there were ‘potential challenges for PCTs in securing action on activities from independent practitioners for which there is no direct financial reward' including registers that captured CHD risk.

BMA chair Dr Hamish Meldrum praised the ‘significant improvements' to services, but said they remained concerned a number of trusts were still underperforming.


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