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PBC is a Big Society pioneer



Mo Girach debates where PBC needs to go next under the Big Society policy

Are you ready to be a Big Society pioneer?

Big Society is about ownership and taking responsibility at all levels of the NHS – GPs, practice staff and the public.

Why is ownership so important? Because with ownership comes quality and innovation and everyone working to meet the same outputs.

NHS provider unit staff already have the Right to Request, which allows them to set up their own social enterprises. And the drive for clinical leadership shows that policymakers realise the effectiveness of staff being engaged with what their organisation is trying to do.

With ownership you can work to a collective mission and outcomes.

With this, comes responsibility and accountability – and in the future we may well see more financial incentives for NHS staff to strive for. Staff bonuses have been given by some foundation trusts already.

GPs will be open to the concept of ownership because of their experience of out-of-hours. Out-of-hours co-operatives were successful because GPs had the autonomy and full control of service delivery – and so could respond well to the peaks and troughs in demand. There was collective responsibility, collective ethos and collective accountability.

The huge challenge ahead will be to give patients ownership of their own health and wellbeing. We need to tackle the dependency culture that has developed among patients and to introduce responsibility, providing the support necessary to achieve this.

For example, the obese patient needs to not only see their GP but also take up a programme of exercise, see a nutritional specialist and follow a sensible diet.

A starting point is to increase signposting to services for patients in these lean times, perhaps via health trainers. But this will also require resources from PCTs and incentives for patients.

There is no doubt that with the Big Society philosophy the new Government will be keen for PBC groups to take on real budgets and we await more information on what these will mean in terms of what is going to be devolved and what the accountability framework will be.

The benefits of having the ownership by staff and patients will make things easier for commissioners. If people own something they will put quality at the heart of what they do and will innovate to make it better.

Which means commissioners will get more for their money.

Mo Girach is social enterprise lead for the NHS Alliance

Mo Girach is social enterprise lead for the NHS Alliance