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West Midlands Metropolitan County – hopes for PBC reinvigoration

Although PBC has a lot of potential, many GPs in Birmingham have become disillusioned with it, says Dr Aamir Syed, LMC chair of South Birmingham PCT and chair of Hall Green Health PBC cluster.

Although PBC has a lot of potential, many GPs in Birmingham have become disillusioned with it, says Dr Aamir Syed, LMC chair of South Birmingham PCT and chair of Hall Green Health PBC cluster.



‘It's a shame as there is still the possibility we can make it work, but only if PCTs are prepared to let go of the purse strings,' he says.

Experience of PBC in Birmingham varies widely with some localities further ahead than others. In South Birmingham, which has four locality groups, PBC clusters have allocated a proportion of their budget to refer patients with suspected DVT and cellulitis to be assessed and treated in the community.

An audit has yet to be carried out on the services, which were developed by South Birmingham PCT. However, feedback is positive and expected savings from reduced hospital admissions will be used to fund these schemes.

Unfortunately, these successes are the exception not the norm, Dr Syed feels, and getting projects set up, particularly small schemes, has been like ‘banging your head against a brick wall'. He says: ‘If it's a PCT-wide service, you're talking about major consultations with all parties, and then two years down the line you still don't have a service up and running.'

In Coventry, PBC is a tale of two main groups. The Godiva PBC group has 40 practices with 150,000 patients, and aims to become a community interest company.

For the Gables PBC group the story is ‘less positive', says Dr Manoj Pai, a member of the group and the city's LMC chair. The group is much smaller – with six practices covering 36,000 patients. Dr Pai says the group has tried to be innovative but feels unsupported. He gives the example of a pilot community orthopaedics service where the necessary support from secondary care and the PCT was not forthcoming. Consequently the group was forced to discontinue the scheme This is one of many wasted opportunities, he believes.

Given clinicians' disappointment with its progress so far, PBC needs ‘reinvigorating', he says. ‘Control needs to be given back to GPs so they can develop services to benefit patients without having to get involved in bureaucratic wrangles,' he says.

West Midlands Metropolitan County

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