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The best of times for hard budgets?

Our new blogger - both a GP and a top PCT manager - tackles what a hard budget might mean from both sides of the fence.

Hard budgets for hard times. That's what we hear from my friend Brian Balmer in Essex, and he does have a point. Brain always has a point.

So what's all this about? Let's start by ditching the hard stuff as I've really no idea really what a hard, or come to think of it a soft budget is; but I am clear that we need to find a better way of commissioning.

What do I know about it? I'm a GP and also the CEO of Cambridgeshire PCT.

We've decided in Cambridgeshire that it's time to free the innovative power in primary care to commission and we seem to have tapped into a vein of enthusiasm as we've had more than half our practices wanting to do this covering over 300,000 patients. I've spent the past few days meeting with the potential clusters and have been deeply impressed by their clarity of purpose

So where is this heading…..well we in the PCT now need to work to support all our GPs to develop clusters; that means we downsize and become a smaller strategic body.

Some clusters may seek their support from other providers and this is something we need to encourage so that we develop the very best support to ensure success.

We also need to work with them on developing medical leadership as this in my mind is not just for the short term…..we need to make this change stick.

Why would GPs want to do this? Well, the overriding motivation in my neck of the woods is not the myth of lining their pockets with gold but to improve the patient experience and also to manage the money better than we can.

This is something I fully support. You guys write the scripts and referrals and you are best placed over a group of practices to manage this……and me shouting at you about referring too many patients is not really going to work.

But this is not easy…..and we need to do this together fostering developing and nurturing. The challenges we jointly face are very significant but it's time to face them together

We started with hard times but we end with ‘these could be the best of times.'

Dr Paul Zollinger-Read is a GP and chief executive of NHS Cambridgeshire

Dr Paul Zollinger-Read