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Co-terminosity



Practical Commissioning’s Jargon Buster explains the meaning of the term ‘Co-terminosity’.

Last heard of in the most recent round of PCT re-organisations in 2006, co-terminosity is back on the Department of Health’s agenda.

Originally it referred to aligning PCT boundaries with local authorities to encourage joint working and commissioning. The latest NHS operating framework states ‘co-terminosity can be used as a driver’ in meeting the central target of slashing management and administrative costs across SHAs by 30 per cent by 2013/14. It states ‘provider arms are to be included in this aggregate’.

The idea is that integration between community services and other parts of the NHS could lead to cost savings. However, the expected trend towards vertical integration with acute trusts will add layers of complexity. Clearly many hospitals do have the same catchment as councils or community services – indeed patient choice increasingly means provider geographical boundaries are becoming fuzzy, if not disappearing entirely.

There are also questions about the implications for jointly funded posts between local authorities and PCTs, and the eligibility criteria for social care, which differs between councils. In this context, leading Practice Based Commissioners suspect co-terminosity will prove hard to achieve and is unlikely to deliver vastly reduced administrative costs.