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The King's Fund, an independent charitable foundation working for better health, and the NHS Alliance, the organisation that represents primary care professionals, have co-published: Practice-based commissioning—from good idea to effective practice.1

Introducing this report, the authors highlight that, although 'universal coverage' of practice-based commissioning (PBC) was announced by the Department of Health back in February 2007, what this means in reality is that an environment has been created in which PBC could flourish rather than is flourishing.

The results of a straw poll of over 250 GPs and practice managers, which aimed to gain the view of the general practice front line regarding PBC, were used by the authors as the basis of the report into effective PBC:

PCT support

Most respondents answered negatively when asked about PCT support, responsiveness, and involvement in planning: only 30% of respondents considered the support given by their PCT 'quite good' or 'very good', with 33% rating it 'poor'. So how can PCTs and practice-based commissioners work more closely together? The report recommends that the PCTs should produce an annual report itemising the changes to patient care or local health that have come about as a direct result of PBC during that year. In addition, it suggests that both PCTs and practices should aim for quick and visible wins, thereby demonstrating the value of PBC and keeping front-line clinicians engaged.

Impact on patient care
Over 50% of respondents reported that, to date, PBC has had no impact on improving care. However, on a more positive note, the majority of those questioned felt that PBC will improve the quality of patient care in the future.

Financial planning
With regards to agreeing an indicative budget with their PCT, 70% per cent of respondents reported that they had not done this for the year 2006–2007. In this month's issue of Guidelines in Practice (here), Dr Jenner, PBC Lead for NHS Alliance, discusses the importance of budgeting for PBC. He highlights that now is the time to ensure that you have agreed your PBC budget for the year 2007–2008 with your PCT. To help you with this process, Dr Jenner has listed ten important criteria that your budget should observe.

Commitment to PBC
Responding to the questionnaire, an encouraging majority (73%) reported that they were committed to PBC. Translating this into effective practice is the challenge. Practice-based commissioning—from good idea to effective practice discusses what needs to be done to speed up implementation, and provides a list of key recommendations.

Julia Morris, Editor
julia.morris@mgp.ltd.uk

References

1. Lewis R, Curry N, Dixon M. Practice-based commissioning—from good idea to effective practice. London: King's Fund, 2007. http://www.kingsfund.org.ukG