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View from the SHA boardroom

Oliver Phillips, head of commissioning and planning at NHS South East Coast, offers his perspective on progress in the region

Oliver Phillips, head of commissioning and planning at NHS South East Coast, offers his perspective on progress in the region

We have been discussing results of the latest DH PBC survey with PCTs, who in turn will share the results with local PBC consortiums.

There is a tangible increased momentum behind PBC locally, which is backed up by the overall improvement in the PBC survey results. Enthusiasm for the policy from practices across the South East Coast region has grown in each of the five quarterly survey results. Initially PBC was taken up by practices with a particular interest in commissioning; as PBC has demonstrated its effectiveness more practices have taken it up and the base has broadened so that now there is much more widespread engagement and support for PBC.

PBC has been successful in a number of areas, most notably in redesigning pathways so that care can be delivered more closely to patients in their homes. Support among GPs for PBC is rising and now stands at more than 60% of those questioned.

Caution needs to be exercised when looking at an individual wave's results at an individual PCT level, because of the small sample size. For example, West Sussex's response for indicative budgets was low in quarter 4, but between 60% and 70% for waves 1-3 and wave 5. Medway consistently scores above the national average in terms of quality of managerial support.

The proportion of practices that say they have commissioned new services has risen to 60% over the past five waves – above the national average. We hope and expect this will rise over future quarters, but we must also recognise that some practices may never wish to be directly involved in commissioning and PCTs will work with them to find alternative ways of developing services.

There has been a significant increase in the scope and scale of services provided in primary care as a result of PBC, although no figure has been put on this across the region.

All PCTs have sent out indicative budgets and regular budget statements to all practices in South East Coast.

The relationship between PCTs and PBC consortiums is good, as is borne out by the PBC survey. All PCTs have established clear and proportionate mechanisms for approving business cases. Our PCTs are above the national average in accepting business cases for service redesign, according to the quarterly survey. This indicates a productive working relationship between PCTs and PBC consortiums.

As part of the World Class Commissioning programme, the SHA is ensuring that all PCTs in NHS South East Coast see clinical engagement in the commissioning process as a high priority. In addition, PCTs are now making development plans to ensure primary care clinicians are supported to take a key role in the commissioning process.

How GPs in NHS South East Coast rated their PBC experience so far South East Coastal SHA

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