Exclusive - GPs call for more PBC support

More than 80 per cent of practices are involved in practice-based commissioning (PBC) but nearly a third of them have not received indicative budgets from their PCT, a survey shows.

More than 28 per cent of practices that were taking part in PBC told the National Association of Primary Care (NAPC) that their PCT had not allocated a budget and was offering inadequate support.

The DoH deadline for PCTs to set practices' indicative budgets was April this year.

Around half of practices that were not involved in PBC said they had not taken part because their PCT had provided too little information or support.

Maggie Marum, an NAPC primary care consultant who compiled the survey, said that a survey conducted last year of NAPC members and non-members showed similar levels of interest from each group.

'Historically a lot of our members are fundholders, so they may be more likely to get involved.'

The survey was sent to a random sample of 250 NAPC members and received 98 responses.

The survey asked practices that were involved in PBC to identify barriers to its implementation in their area.

About 22 per cent said the incentives on offer for PBC were inadequate or non-existent.

Time pressure or lack of protected time was cited as a barrier to implementation by 18 per cent. A lack of data or inadequate data quality was a key concern for 13 per cent of practices.

PCT deficits, inability to make savings, and PCT restructuring were a concern for around one in 10 practices.

GPC negotiator Dr Richard Vautrey said he was not surprised at the high number of practices involved, but he pointed out that only a handful were likely to be involved in a meaningful way.

'I expect no more than 20 per cent of practices that are involved are doing any meaningful commissioning work - just signing up to the directed enhanced service is not real involvement,' he said.

Dr Vautrey said he would have expected a higher proportion of practices to report concerns about a failure to set budgets and lack of support from PCTs.

'Many practices have seen no budgetary information at all. Two months into the financial year, it is very frustrating for practices not to have a baseline from which to work,' he said.

The level of involvement in PBC among GP practices in the NAPC survey far exceeds the findings of a GP survey earlier this month, which found that 42 per cent of practices were involved (GP, 9 June).

The results appear to support feedback received by the DoH from SHAs indicating that all PCTs are on track to achieve 'universal coverage' of PBC by the end of the year.

BARRIERS TO PBC
- PCT failures to set indicative budget.
- Inadequate or non-existent incentives.
- Time pressure.
- Lack of data.
- PCT deficits.

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