GP concern over PCT mergers

GPs believe that some SHAs' proposals on how PCTs should be reconfigured could mire them in bureaucracy.

They say creating PCTs that straddle SHA and local authority boundaries, such as those proposed in Doncaster and Wessex, would scupper service development plans. It would also run counter to the government's aim of strengthening relationships between healthcare and local authorities by moving towards more PCT and local authority coterminous boundaries.

In a submission to the House of Commons' Health Select Committee earlier this month, the DoH said that the reconfiguration, called for last year in its document, Commissioning a patient-led NHS, would bring boundaries closer together.

It said: 'Just over 40 per cent of PCTs are coterminous with local government boundaries. Subject to the outcome of local consultations, we expect that this will rise to nearly 80 per cent.'

GPs in Doncaster have been campaigning against a reconfiguration option, which would see the amalgamation of Bassetlaw PCT with the three Doncaster PCTs.

Doncaster LMC secretary Dr Rosie Hamlin said: 'If Bassetlaw does come to Doncaster, it will tie us up in red tape. Doncaster's PCTs have always worked together and they are coterminous with the local authority. The LMC would support their merger into one PCT because there is already a lot of collaborative work.'

However, if Bassetlaw were to be included, the PCT would cross so many boundaries it could be unworkable, she added.

'The PCT would no longer be coterminous with local authority social services and education departments,' she said.

'Part of Bassetlaw would be in one SHA, part in another. Practice-based commissioning could also be hit.'

Other services do straddle the boundaries, including the deanery, ambulance services, regional development agencies, the health protection unit and the police.

The Bassetlaw option was proposed by the DoH as a means of providing 'consistency with primary catchment areas for South Yorkshire acute trusts'.

Avon LMC chief executive Steve Mercer has similar concerns about a proposal in his area that would see Bath and North East Somerset PCT merged with another in Wiltshire.

'You'll break up the good work that's been done if you try to get health communities working with more than one county,' he said.

Wessex LMC chief executive Dr Nigel Watson said he was happy to have fewer PCTs to deal with, but worried they might not respond to local issues.

Local consultations on the reconfiguration ended this week.


March 2006 End of consultation
October 2006 PCT mergers completed
April 2007 End of SHA reconfiguration

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