DoH urged to give GPs real budgets as PBC 'fails'

Practice-based commissioning (PBC) has failed and real commissioning budgets should be devolved to GPs, the King's Fund has said.

A report by the think-tank this week warns that 'PBC is not operating effectively'.

It calls on the DoH to devolve real budgets for commissioning specific services to GPs and PBC clusters.

Responsibility for strategic population-wide services such as public health would remain at PCT level.

National Association of Primary Care president Dr James Kingsland backed the recommendations. He added that they reflected how PBC was originally meant to work.

'The King's Fund is reiterating an idea Tony Blair had seven years ago.'

The researchers found that PBC had little impact on services. Instead, its most visible impacts had been in improving - or destroying - relationships between GPs and PCTs.

The report identifies a number of reasons for this failure, including GPs' lack of free time, poor quality of data, and the DoH's failure to explain how the policy worked and what it should achieve.

The failure to align power with financial responsibility or tackle conflicts of interest had also proved to be blocks.

The lack of progress is eroding the enthusiasm of the few GPs who embraced the policy, the researchers warned. If the situation is not tackled soon, 'what modest progress has been made will be lost', they concluded.

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