Primary care trusts could be cut by 50 per cent
The number of primary care trusts in England will be cut and rapid progress made towards universal practice-based commissioning by the end of 2006, according to a Department of Health document “Commissioning
a patient-led NHS” published last week.
The document says that PCTs are to be reconfigured to “improve
co-ordination with social services through greater congruence of PCT
and local Government boundaries”. There are 150 local council social
services departments in England (compared with 303 PCTs). However, the
document states that reconfiguration does not mean a rigid one-to-one
relationship between PCTs and social services departments.
In addition, PCTs are expected to make arrangements for 100 per cent
coverage of practice-based commissioning. John Carr, pharmacist member
of the professional executive committee at East Staffordshire PCT, pointed
out that the document is silent on the issue of clinical involvement
in the management of PCTs. He told The Journal: “I am concerned
about how pharmacy, as well as other colleagues such as therapists, optometrists
and dentists, would have a voice in determining local priorities in newer,
and potentially much larger, PCTs.” The document assumes that clinical
representation from practice-based commissioning is the only necessary
clinical involvement and disregards some of the impact that nurses, therapists
and pharmacists have made to providing an alternative series of services,
he added.
Reorganisation of the NHS is required to meet the Government’s
commitment to save £250m in overhead costs and the document specifies
that proposals to merge or reconfigure PCTs must deliver at least a 15
per cent reduction in management and administrative costs. |
The
Pharmaceutical Journal
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