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Trusts fail to give practices adequate support for PBC

Seven out of 10 practice-based commissioners say PCTs are failing to support them, according to a report jointly produced by the NHS Alliance and the King’s Fund.

By Rebecca Norris

Seven out of 10 practice-based commissioners say PCTs are failing to support them, according to a report jointly produced by the NHS Alliance and the King's Fund.

The lack of support is leaving practices without mutually agreed budgets, accurate or timely data or senior staff to answer day-to-day queries about PBC.

A straw poll carried out for the two organisations, answered by 257 GPs and practice managers, showed 70 per cent of respondents rated PCT support as ‘not very good' or ‘poor', while the same number of respondents said they did not have an agreed budget.

Nearly half (46%) of respondents who were forecasting budget savings did not believe they would be allowed to keep a 70% share – contrary to Department of Health guidance – while 38% were unsure whether the entitlement would be honoured.

NHS Alliance chair and report co-author Dr Michael Dixon said: ‘I think the most worrying feature here is the fact that only a third of respondents say that the support given out by their PCT is good or quite good, because the whole thing is going to flounder if we haven't got PCTs and practices mutually supporting each other, going forward.'

He added: ‘The good news is that the survey also shows around three-quarters are highly committed to PBC and feel it will deliver for patients over the coming year.'

The report blames the lack of support on the restructuring of PCTs last year, as well as unwillingness by some PCTs to devolve commissioning functions. Strategic health authorities needed to ‘get their hands dirty' by checking how much support PCTs were actually giving to practices.

The report calls for PCTs:

• to agree budgets and incentive schemes with practices urgently

• assign senior officers to act as a key contact for practices on PBC issues

• to consider establishing ‘innovation risk funds' to underwrite innovative PBC plans that might otherwise be put on hold in the cash-strapped NHS environment.

The department should also consider setting three-year financial cycles to support longer term ‘invest-to-save' schemes.

The report was unveiled at the NHS Alliance spring conference.

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