GPs and PCTs told to lead change

GPs and primary care trust managers need to start developing solutions for GP commissioning now, according to joint advice issued by two GP and PCT organisations.

The National Association of Primary Care and the NHS Confederation’s PCT Network have published a paper setting out what they believe should be the first steps for GPs and PCTs trying to implement the white paper ‘Equity and Excellence -Liberating the NHS’.

It says PCTs and GPs should make the most of the Department of Health’s aim to move away from a top-down system of management.

The paper adds: “We should take them at their word and start to design solutions locally now from the bottom-up rather than waiting for guidance from above. This requires strong leadership with the right attitudes, behaviour and vision.”

However the two organisations also warn that GPs and PCTs should not rush into setting up new structures before they have worked out what they want to achieve.

The paper says there may be a natural tendency for discussions to focus on planning organisational structures and fitting roles around people “particularly when people are anxious about their futures.”

Instead it says the most important first step at local level will be constructive dialogue between GPs and PCTs, with the discussion focusing on what functions will need to be delivered and what will need to be different.

They say there will be no need for consortia to abandon everything that has been done by PCTs.

“Equally there is no point in simply transferring the current approach in PCTs and replicating it in GP commissioning consortia, not least because the required management savings would make this impossible.”

The NAPC and the PCT network say PCTs will also have an important role in facilitating a new relationship between local authorities and GPs which it says will be essential to make the new system work.

The NHS Confederation’s PCT Network has also released its analysis of PCTs’ latest world class commissioning assessments. It says this shows significant improvement among trusts.

The network’s analysis of second year reports on 142 out of 152 PCTs found a significant improvement across all areas, including governance, key outcomes and 11 defined competencies.

The competencies cover a range of stills for commissioning including managing knowledge and assessing need.

The PCT Network said there was an average improvement of 39% across the ten competencies which were assessed in both years of the programme.

David Stout, director of the PCT Network, said: “Despite coming in for criticism recently almost all PCTs have shown they are working more effectively to engage with clinicians, patients and the public and are using their commissioning skills to help drive up standards of care.”

Stout said the competencies in the world class commissioning framework were relevant to the new system of GP led commissioning and that the NHS would still need to have access to the same range of competencies.

He added: “The transition to GP-led commissioning will require strong and engaged leadership and these results highlight the fact that PCTs have the specialised knowledge and skills required for an effective handover.”