GPs hope for share of £1.4bn as managers under threat

Posted on November 19, 2009. Filed under: News stories | Tags: , |

Healthcare Republic | Neil Durham | 19 November 2009

GPs are hoping for a share of the £1.4bn running costs of strategic health authorities (SHAs) and PCTs if they are slimmed down.

NHS chief executive David Nicholson signalled that the future of SHAs and PCTs was under review when he questioned their value at the annual meeting of the National Association of Primary Care (NAPC) in Birmingham on Wednesday.

GPs looking for incentives to make real their plans for community health collaboratives of ‘foundation practices‘ holding real budgets were heartened by Mr Nicholson’s speech.

Mr Nicholson said: ‘We spend £1.4bn on SHAs and the running costs of PCTs. Can we genuinely say that money is spent to the best effect?

‘Can some of it be spent much better? Can we organise ourselves much better? The answer is undoubtedly yes. These are the issues we need to tackle.’

He described the £20bn savings that would need to be found 2011 to 2014 as a ‘massive challenge’. He welcomed the emphasis of the Darzi review on quality.

He said: ‘It’s perfectly possible to improve quality and reduce costs simultaneously.’

Mr Nicholson described primary care as ‘critical’ to this goal because it was at the ‘heart of solutions’.

He said a transformation of community services was key and that plans ‘to give it a real sense of direction and pace’ would become public at the end of this year

Mr Nicholson added: ‘The potential of commissioning is enormous but now it needs ambition and drive to make it a reality. I welcome the NAPC manifesto. We need to make sure that we have a real system that can bring people from dependence on their PCTs to one where they have some independence from PCTs and more power to invest money in the way you want. That has to be earned.’

Key was enabling PCTs to give away power to clinicians on the frontline who were the only ones who could truly make a difference to patient care.

Afterwards Dr James Kingsland, NAPC president, said: ‘£1.4bn? We could do something with that.’

Dr Kingsland expects a greater emphasis on practice-based commissioning (PBC) in the NHS operating framework to be published early next month

Dr Peter Smith, NAPC vice president, said: ‘I would like to see more management devolved down to practice level to start doing PBC effectively, so our managers are working for primary care rather than seeking to control it.’

He described it as more than incentivising community health collaboratives. ‘We need a lot of good information at primary care-level it just isn’t there. We need to start putting resources into accurate activity information.’

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Labour backs real budgets to revitalise PBC

Posted on November 18, 2009. Filed under: News stories | Tags: , , |

Healthcare Republic | By Neil Durham | 18 November 2009

An idea to revitalise practice-based commissioning (PBC) by allowing groups of practices to hold real budgets has been welcomed by England’s health minister Mike O’Brien.

Speaking at the annual National Association of Primary Care (NAPC) conference in Birmingham on Tuesday Mr O’Brien broadly welcomed the group’s manifesto.

It says that PBC success has been limited and that urgent action is needed.

The 14-page document suggests local practices should form community health collaboratives (CHCs), which would be given real budgets.

The patient voice would be heard in the design of services and also how the health dividend, or freed-up resources, is spent.

PCTs would set headline commissioning outcomes for a population and agree contracts with CHCs.

Once practices have delivered the appropriate quality of primary care services they would qualify to become ‘foundation practices’.

Management resources would transfer from PCTs to develop CHCs.

Mr O’Brien said: ‘Foundation practices would have much greater independence to run budgets. I welcome these ideas. I think the NAPC is bringing forward interesting proposals. The government wants to look at this with great care.’

In a speech that was far more party political than his address to the RCGP conference in Glasgow earlier this month, Mr O’Brien sought to outline the differences between Labour and Conservative party policy on the NHS.

Mr O’Brien explained that smaller practices would not be forced into CHCs or to become foundation practices.

He said: ‘Some smaller practices could be broken if forced to manage budgets. Practices would have the choice rather than forcing them as some would do.’

Once again the theme of Mr O’Brien’s speech was that improved quality would result in savings, so important as the NHS has identified that £20 billion must be found to maintain services between 2011 and 2014.

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NAPC proposes radical plans for primary care

Posted on November 18, 2009. Filed under: News stories | Tags: |

Pulse | By Gareth Iacobucci | 18 November 2009

GP leaders have unveiled a radical new model for primary care, with practices able to manage large chunks of the local healthcare budget and attain the status of ‘foundation practices’.

The National Association of Primary Care has proposed GPs are given more freedom to design services and manage ‘capitated budgets’ for their local communities.

The ideas were launched at the NAPC annual conference in Birmingham today and were welcomed by a Government minister who said they would look at the idea ‘closely’.

The manifesto calls for the development of ‘community health collaboratives’ with PCTs setting the outcomes they want to achieve.

GP practices would then receive budgets for the whole patient pathway and be able to design services and manage the reinvestment of any freed-up resources achieved.

Successful practices would then be able to attain the status of a ‘foundation practice’ if they can demonstrate they have the ‘appropriate quality’ of services in a similar way to hospital trusts.

NAPC chair Dr Jonny Marshall said PBC needed to be ‘resurrected’ and this was a way of ensuring GPs were given more freedom to locally manage PCT resources.

‘Practices will not only be responsible for the care they deliver, but also for their impact on the finances of the health system.

‘We need to focus on transforming the health service rather than re-disorganisation,’ he said.

Health minister Mike O’Brien said he welcomed the idea of transferring greater independence to practices from PCTs.

‘We will want to look at the idea with a great deal of care,’ he said.

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