No more PBC incentives available, czar warns

Primary care czar says enough GPs are involved in practice-based commissioning for viability.

GPs will not be offered any more incentives to engage in practice-based commissioning (PBC), the DoH primary care czar has said.

Enough GPs are already committed to PBC to make it work, and the rest of the profession will follow in time, England's clinical director for primary care Dr David Colin-Thome said.

'Even if it's only 30 per cent of GPs, and I think it's higher than that, that's a significant way of getting change.'

Dr Colin-Thome spoke to GP after the DoH's strategy to rejuvenate PBC received a lukewarm reception at its launch in London last week.

The panel discussing the DoH 'vision document' said it contained too much 'management speak' and would not necessarily solve practice-level problems.

The strategy aims to ensure PCTs provide swifter support and budgets for GPs.

Clinicians can expect to have their PBC budget and any other PCT support agreed by 1 May each year. PCTs will not be able to progress through the 'world-class commissioning' ranking system without improving PBC.

Dr Colin-Thome denied that recent DoH policy, high workload and low morale were responsible for a lack of enthusiasm for PBC among GPs.

'There are enough GPs who are enthused. Once the good guys start whizzing along and changing PBC, like fundholding and PMS, others will follow.'

He said the size of practice budgets and the management support PCTs would fund would remain for local negotiation.

Clinical Commissioning: Our Vision for Practice-Based Commissioning is the DoH response to Lord Darzi's Next Stage Review, which committed to 'reinvigorating' the policy.

But Mike Sobanja, chief executive of the NHS Alliance, warned: 'If you want to enthuse clinicians, it's not the best idea to use "management speak".'

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