PBC postcard: Dr Bill Tamkin

Chair of Manchester Practice-Based Commissioning (South)

• I like to think I became chair of our PBC group by popular acclaim. However I suspect I was slowest to avoid eye contact when a volunteer was being sought.

• If I wasn't chair I'd have more time to see my patients, be with the grandchildren and do DIY – which I'm hopeless at, so my wife is particularly grateful for PBC.

• PBC is engrossing and really a full-time job. My practice is reimbursed for four sessions a week. A streak of altruism keeps me going – and the fact that I'd never make a living as a handyman.

• We chose Manchester Practice-Based Commissioning (South) as our snappy company name in recognition of Manchester's Central and North PBC groups.

• Encouraging is the word that sums up our PCT's attitude to PBC.

• Frustrated encapsulates our GPs' attitude to PBC – a sense of being stuck and not able to move on as fast as we'd like.

• Increasingly positive encapsulates our local trust's approach to PBC – a sense that we are part of the solution rather than a problem.

• Our greatest achievement is five years of corporate working, which has given us leverage to change the way services are provided for our patients, and to set up new services such as minor surgery and the nursing home service.

• My greatest achievement is keeping all the practices sufficiently on board to develop our own social enterprise company.

• The most frustrating thing about PBC is that it takes so much time to get anything done.

• I am optimistic that PBC is one of the keys to manage the NHS's fiscal black hole – if it is properly empowered in its gatekeeping role.

• The biggest threat to PBC's success is loss of momentum. Without clearly defined responsibilities, empowerment and budgetary influence, many enthusiastic GPs will drift away to the day job where they can make a bit of difference to those they care for.

• PBC would be transformed overnight with accurate budgets, real-time activity information and a business case approval process that turned around cases in less than a month.

• In five years' time PCTs' role will become more strategic as PBC takes on more and more of their current day job.

• In five years' time I hope to be still seeing patients, but not quite so many;, seeing more of the family and still avoiding DIY.

We're seeking similar postcards from those at the coalface of PBC. Email submissions or expressions of interest to us at practicalcommissioning@ubmmedica.com