Suffolk - the PMS factor
In Suffolk, there has been strife between GPs and the PCTs over renegotiation of PMS contracts and 80% of GPs rated managerial support as ‘poor’.
In Suffolk, there has been strife between GPs and the PCTs over renegotiation of PMS contracts and 80% of GPs rated managerial support as ‘poor'.
Bill Richardson, chief executive of Suffolk LMC, says: ‘The renegotiation of PMS contracts probably took people's minds away from PBC and because it was tense it broke down some relationships.'
But he adds: ‘There's every sign things will move on now.'
Aside from the organisational conflicts, PBC has also been held back by data problems. Dr John Havard, a GP in Saxmundham, who chairs the Commissioning Ideals Alliance covering 60,000 patients on the Suffolk coast, says: ‘We've had some good examples – we've had voice-recognition ultrasound, which provides reports directly. But we've seen some crass failures as well.
‘We had a DVT project that was unanimously backed by the PBC committee, but the PCT said No because they found we had been given the wrong data.'
The scheme was designed to save patients a 50-mile round trip for scans in hospital, only to have to re-attend for treatment. Despite the failure to launch the project, Dr Havard believes that ‘some good' came of it, as the hospital is going to put ultrasound in A&E to assess suspected DVT.
But PCTs are not the only source of aggravation for GPs when it comes to commissioning new services. In Ipswich, GPs found the local hospital trust uncooperative when business plans for cardiology, urology and gynaecology were unveiled.
Dr Paul Bethell, a GP in Ipswich who is on the executive committee of IpsCom, which represents the town's 17 practices, explains: ‘There's been a problem getting the hospital to provide consultant input - they worried it was going to be detrimental to their income.
‘We've reached agreement where it will be in their interest and the patients'. What's been to their advantage is that particularly for cardiology there are huge outpatient waits and they can't solve it any other way.'Suffolk