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More of the same?

Dr Paul Zollinger-Read considers whether pathfinder consortia represent a fundamental change in direction

So we now have over half the country covered by pathfinders; there is no doubt about it the level of interest and enthusiasm is high. We have all the ingredients for success; or is there perhaps a missing ingredient?

PCTs are now reducing into 50 or so clusters as we have done in Cambridgeshire and Peterborough and these will become the transition organisations. They have been tasked with assigning and aligning staff to consortia and to developing commissioning hubs to support the consortia. This will be challenging but a clear direction and pace has now been set and I'm confident this will progress. The area I'm having difficulty with is very different. In fact, it's just that…..DIFFERENT.

We are working closely with consortia supporting both leaders and the developing organisations. This covers a variety of areas form coaching, to workshops on finance (very popular), to support on commissioning skills.

But ... we are largely thinking within the box that we have always been in. My fundamental question is ... 'so what are we doing differently?' In the words of Don Berwick: 'If you do more of the same you'll end up with the same old results.' Consortia are very different from previous commissioning organisations; they are not and must not be PCTs.

For me this goes back to understanding the value that consortia bring. There are differing views on this, but they need to be understood locally. We then need to look at how we can work with consortia to help them realise this value and I think when we start to ask these questions we may realise that the type of support and the development of these embryonic organsiations may take differing directions form the previous organsiations we have created. Part of this value will be around how they are grounded in the local community and how they create a more wider societal value.

None of this is easy but we have an immense opportunity to get this right; my advice ... if it looks and smells familiar we ‘re going down the wrong road.

Dr Paul Zollinger-Read is a GP and director of GP commissioning at NHS East of England

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