Information barrier to PBC

Poor quality data and financial information remains a barrier to the successful implementation of practice-based commissioning, according to the National association of Primary Care.

The NAPC, whose membership covers GP practices and PCTs, is calling for timely financial and clinical data to be made available to practices. It claims the future of practice-based commissioning is in the balance but argues that it needs refreshment rather than reinvention.

The Association conducted a review of progress between November 2008 and January 2009 that included an email survey of its members, exit questionnaires at two events and a series of six regional evening seminars.

The NAPC said the review found that additional barriers to the adoption of PBC were GP morale and workload, PCT reluctance to support PBC, slow approval of business cases and conflict between PCT provider and commissioning functions.

Dr James Kingsland, NAPC president, said: “The barriers and solutions to the successful implementation of PBC have remained largely unchanged in recent years.

"Whilst there has been progress towards the adoption of PBC at practice level, with pockets of good practice identified around the country, there still remains a significant tranche of general practice which is either disengaged or disenfranchised.

“We look to the Department of Health to seek the support of leading organisations, such as NAPC, in the scheme’s future roll-out and success.”

The review identified four ‘successes’ in implementation to date, including IT systems developed to support practice based commissioning and clinical ownership of service redesign.

The NAPC said PCT engagement was essential to the success of the team and there should be “real performance management” of PCTs where PBC failed to thrive.

Dr Johnny Marshall, chair of the NAPC, added: “With the correct levers to refresh the scheme, coupled with engagement on the part of general practice, there is no reason why we should not see a modernisation and transformation of health services both in primary and secondary care to meet today’s patients’ needs.”

Later this week, Dr Mike Dixon, chair of the NHS Alliance, will also argue that PBC is more crucial than ever in today’s economic climate, offering more cost-effective and appropriate local services.

In a keynote speech to a joint NHS Alliance and King’s Fund conference, Dr Dixon will say that although PBC has been going for almost four years, the number of successful groups is still small.

He will add: “The NHS was promised that the traditional 80% central direction versus 20% local self determination would be changed to 20% central and 80% local. This has not happened.

"The NHS remains centralist with secondary care-centric leadership. This is not only hampering progress of ‘a primary care-led NHS’, it is also a major factor in stifling practice based commissioning.”