Editorial: Clearer guides needed on vascular screening

It is all too easy for ministers to talk about the need to devolve greater responsibilities to primary care organisations.

After all, why should the mandarins in Richmond House, Whitehall, decree standards of service that could be better decided in the areas where they apply?

This week's GP reveals exclusively that more than a third of PCTs have yet to begin carrying out vascular checks and just one in 20 have so far achieved the uptake required to hit government targets.

So what's the problem?

A GP with an interest in CVD believes that clearer advice on the benefits of screening and guidance on how it could be successfully implemented would have helped PCTs.

Each PCT was left to decide how vascular risk should be assessed and what tests should be used to diagnose conditions such as diabetes.

'PCTs are always trying to save money and this involves spending more money,' the GP adds.

Funding was not ringfenced, which reduces the impetus to push the programme through, points out the Primary Care Cardiovascular Society.

The Tories have threatened to axe the vascular screening programme, casting doubt on its cost-effectiveness and suggesting it originated from 'a great idea in the bath'.

What is clear is that PCTs lack guidance about which strategies work best.

Last week, primary care minister Mike O'Brien said there was an 'unacceptable variation' in PCT-provided out-of-hours care in England and made recommendations to improve nationally-set standards.

The same solution is needed to tackle the poor uptake of vascular screening in PCTs.

When will ministers learn that too much talk of devolving responsibilities to PCTs begins to sound less like empowering the frontline and more like passing the buck?

What vascular screening needs to become a success is research into best practice, dissemination of evidence and the ringfenced funding to make it happen.

Exclusive: Third of PCTs stall on vascular checks

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