The Pharmaceutical Journal
Vol 279 No 7480 p610
1 December 2007

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Practice-based commissioning resources

Report highlights little progress in implementing PBC

Redesign of health care services and their transfer from secondary to primary care has yet to gather pace under practice-based commissioning, according to an Audit Commission report published last week.

The commission visited 16 primary care trusts and three GPs at each PCT to examine local commissioning arrangements. It also conducted a survey of 122 GPs and practice managers, and reviewed findings from local audit work.

“It was clear that many practices were more interested in using their budgets for the direct provision of new services rather than to commission others,” the report says. It adds that, in both cases, there needs to be more consistent provision and proper assessment of business cases to ensure best use of available funds.

The report highlights the need for strong governance arrangements to overcome any potential conflict of interest. “We found that PCTs’ approaches to business cases were generally underdeveloped, as were arrangements for monitoring the impact of any changes,” it says.

The commission found that PCTs experienced considerable difficulty in setting indicative budgets and providing these to practices in a timely way. Provision of information to practices to support PBC was also lacking.

Where there had been some success in implementing PBC, it was largely due to a small number of enthusiastic practices working closely with supportive PCTs, says the report.