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PCTs 'worst performing part of NHS'

By Gareth Iacobucci

PCTs have performed worse than other health sectors for the second year running in the Healthcare Commission's annual healthcheck of NHS trusts.

Although performance ratings for all NHS trusts in England showed an overall improvement in quality of services and use of resources, the performance of PCTs was behind that of acute, mental health and Foundation trusts.

62% of PCTs were rated ‘fair' for quality of services, with 12% rated ‘weak' in this area –up from 8% last year.

A lower proportion scored ‘excellent' or ‘good' ratings for quality of services, although the proportion scoring ‘weak' for use of resources fell from 41% to 29%.

Choose and Book and the updating of practice-based registers were earmarked as areas of particular concern. The commission highlighted a ‘distinct difference' in per-formance between those PCTs that were reorganised and those that were not, with the 72 PCTs reorganised in October 2006 performing poorest.

While 4% of the 72 reorganised PCTs scored 'good', with none scoring 'excellent', 34% of the 80 non reorganised PCTs scored either 'excellent' or 'good'.

David Stout, Director of the Primary Care Trust Network, said the figures showed that PCTs were ‘still facing challenges' from reorganisation.

He said: ‘Major organisational change midway through a business year has unsurprisingly put a strain on trusts. We need only look at the data to see that PCTs that have not been reorganised are performing at a similarly high level to the rest of the NHS.

Dr Stout said any further upheaval to governance of PCTs would be ‘disastrous for patients'.

‘We must avoid kneejerk reactions which call for unnecessary restructuring and allow PCT managers to focus on delivering the best quality patient services.

‘It is also important to remember that trusts classified as ‘fair' are not failing, and that ‘weak' does not imply unsafe.'

BMA Chairman, Dr Hamish Meldrum praised the ‘significant improvements' to services, but said he remained 'concerned that a number of trusts are continuing to under-perform.'

‘There is a lot of evidence that imposed referral management schemes and problems with the Choose & Book IT system have worked against patient choice,' he added.

‘The BMA has urged the Government time and time again to work with doctors before rolling out expensive software systems but unfortunately this has not happened.'

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