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Schools and nurses join PBC

By Gareth Iacobucci

GPs are to be thrust into partnership with everyone from schools to pharmacists under a new Government strategy to revitalise practice based commissioning.

NHS chiefs have revealed plans for the first Integrated Care Organisation (ICO), in Surrey PCT, as one of a series of pilots of the radical concept.

Plans for ICOs were unveiled in Lord Darzi's recent NHS review, and are set to see teams of GPs, pharmacists, nurses, social workers and school leaders working together to help shift care effectively into the community.

A series of pilots across Surrey will be launched next month, with North East Essex PCT among those due to follow suit.

All practices in the county will be invited to bid to work in teams across health and social care settings, in a model compared with the iconic US Kaiser Permanente scheme.

Front-runners are set to be handed increasing power over budgets and commissioning, focusing on disease prevention, management of chronic diseases and case management, as well as shifting care from hospitals to the community.

Paul Bennett, deputy chief executive of Surrey PCT, said ICOs could eventually hold hard budgets, but admitted this may still be some way off.

Dr Shane Gordon, a GP in Tiptree, in Essex, which is planning to launch its own pilot, described ICOs as ‘the next evolutionary step for our PBC cluster'.

He added: ‘ICOs are very exciting. How impactful they are remains to be seen. They could be a model for deciding what happens to budgets.'

The pilots, set to be followed by others across the country to be announced in the next few weeks, are being viewed by some as a make-or-break initiative for PBC, with the latest Department of Health survey showing the scheme is continuing to stall.

While 46% of practices had commissioned at least one new service as a result of PBC, up from 41% in the last quarterly survey, the percentage of practices agreeing that PBC has improved patient care was just 18%, an increase of 2% from the previous survey.

And although over four out five practices said they were a member of a local PBC consortium, those rating their PCT's managerial support for PBC as poor (48%) continue to outweigh those who think it is good (44%).

Dr James Kingsland, NAPC chair and a GP in Wallasey, Merseyside, said the latest results proved that ‘nothing has changed', and said PBC ‘will have failed' without a dramatic improvement by next year.

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