Successful PBC depends on clinician engagement

Key themes of effective practice based commissioning are stability, time, incentives, organization, and management

The concept of practice based commissioning (PBC) was introduced by the Government back in 1997 with the publication of the white paper The new NHS: Modern. Dependable.1 A further report, Commissioning a patient-led NHS,2 which was published in July 2005, brought the timescale for the implementation of PBC forward to December 2006.This means that by the time you receive this issue of Guidelines in Practice, your practice should be significantly engaged in PBC.

The idea behind PBC is that decision-making regarding the commissioning of services will be the responsibility of GPs and front-line clinicians. This will enable them to use their clinical knowledge and closeness to patients in the process, which should result in the needs of both individual patients and the local population being met by the commissioned services.

Presenting at the NICE 2006 conference earlier this month, Judith Smith, Senior Lecturer at the Health Services Management Centre at Birmingham University, explained that for successful PBC to occur, the following should be in place: stability within the organization; time and incentives to engage and enthuse clinicians; resources to allow movement between providers; and effective management and information support.

To support general commissioning decisions on potential service reconfiguration in England, NICE has developed a number of commissioning guides to be used in conjunction with current national guidance. A tool is available to assist in the financial modelling and costing of service provision in a local area, a framework is provided for investment decisions, and relevant national priorities are highlighted. There are five guides available to date, which can be accessed at www.nice.org.uk, with further guides planned.

As highlighted in this month's news, a number of issues regarding the practical implementation of PBC are clarified by guidance published by the Department of Health.

I am pleased to announce that, from January 2007, the journal will include PBC take home messages in each of the clinical articles. This is one of a number of significant updates to look out for in the next issue of Guidelines in Practice.

Julia Morris, Editor

julia.morris@mgp.ltd.uk

References

Her Majesty's Stationery Office. The new NHS: Modern. Dependable. London: Her Majesty's Stationery Office, 1997.
Department of Health. Commissioning a patient-led NHS. London: DH, July 2005.