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Views from the boardroom and the surgery

Andy Vowles, deputy director of commissioning at NHS East of England, and Dr John Galloway, a GPSI in gastroenterology in Norfolk, give their views on the progress of PBC in the region

Andy Vowles, deputy director of commissioning at NHS East of England, and Dr John Galloway, a GPSI in gastroenterology in Norfolk, give their views on the progress of PBC in the region

Andy Vowles, deputy director of commissioning at NHS East of England, says that progress with PBC in the region reflects the authority's ‘inheritance'.

He says: ‘The journey is a big part of the story for us. When we set up NHS East of England, our starting point was pretty poor – both financially – a £290m deficit (the worst in England) – and we were missing quite

a number of national service targets. The backdrop was relatively bleak.

‘We refer to the turnaround as "laying the foundations" – until you're on top of the money and the must-do targets it's difficult to make progress on PBC. We've consciously had to keep quite a tight hold of the reins, especially financially.

‘The right thing for us to do is think about how to let go and allow PBC to flourish while retaining financial control – and from our perspective it was initially more about retaining some control. Now we've moved through that phase. We've realised that having such a tight control has had an impact on what PBC has achieved.'

Now, Mr Vowles says, NHS East of England is looking to further the PBC agenda through a big push on clinical engagement. It has established a PBC network, comprising both consortium GPs and PCT staff, to allow more sharing of best practice region-wide.

He says: ‘As part of the network, we're commissioning, with the NHS Alliance,

a training and development programme for PBC consortiums. We're advertising for participants and the take-up has been good.'

The authority is also formalising its interactions with its PCTs by developing PBC ‘report cards' showing trusts' trends, numbers of agreed budgets and sign-offs.

Dr John Galloway, a GPSI in gastroenterology in King's Lynn, Norfolk, is pleased with the successes of PBC locally, as it has sustained a primary care endoscopy service he set up 16 years ago under fundholding.

He says: ‘The PCT is still buying the service. The local commissioning group made it a priority to carry on buying, as it was much cheaper for things like colonoscopies – at £350 rather than £800 in hospital.'

Dr Galloway is also seeing innovative benefits that investing savings can provide.

He says: ‘GP commissioning decided to invest in getting the local lab to do hydrogen testing for Helicobacter pylori so we could follow NICE guidelines and reduce referrals and reduce cost of care.'

But he warns: ‘There are areas of commissioning that will be very valuable that aren't often talked about, like education for GPs. Unless all health professionals work with the best knowledge and practice you won't save money.'

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