Official commissioning figures do not add up

GP leaders have hit back at official practice-based commissioning (PBC) involvement figures, saying they are inflated to almost ten times reality.

Last week the DoH released its monthly uptake figures for PBC that claimed involvement by 81 per cent of GP practices nationally and uptake as high as 94 per cent in South West SHA.  

But Dr James Kingsland said that the figures could give false confidence to PCTs and he put the real involvement figure at just 10 per cent.  

Speaking at the National Association of Primary Care (NAPC) annual conference, chairman Dr Kingsland said: ‘Current figures relate to take-up of the enhanced service. They are a fantastic start, but they tell us nothing about real service redesign.  

‘Surveys and straw polls I have done at conferences in the last two months show that practices with actual active devolved budgets and data is as low as 10 per cent — don’t get complacent about government figures.’  

GPC chairman Dr Hamish Meldrum also expressed his concerns over the validity of the DoH figures.  

‘The DoH says that there is 81 per cent involvement — I beg to differ,’ he said.  

‘GPs have a lack of engagement with the grand plan and there are more negative than positive reasons to get involved with secondary care.  

‘Eighty one per cent may have taken up part one of the directed enhance service, but that is different from being involved in PBC.’  

He said that his own practice had taken up the enhanced service money, but all that meant was meeting the PCT to help it overcome its own £20 million deficit.  

‘Are we going to take on a budget in those circumstances? Not bloody likely,’ he said.  

But speaking at the conference  in Harrogate, Yorkshire last week, health minister Lord Warner defended the figures, saying that the DoH was on course to meet its target of universal coverage by the end of the year.  

‘The latest statistics show that 82 per cent of PCTs have put the necessary arrangements in place to support PBC,’ he said.

He said that he recognised ‘there is variation between PCTs’ but that the DES uptake figure of 81 per cent showed ‘a synergy between PCT figures and the GP payment figures’.  

In his speech to the conference Lord Warner also told delegates that commissioning  should be used to improve provision through competition.  

‘PCTs should look to commission services from different providers,’ he said. ‘And by new providers I do not just mean national private sector organisations.  The third sector and social enterprises have much to offer here. We need to introduce competition into primary care as we have done in secondary care.  

‘Alongside this, we need to make it easier for patients to change practices. Existing practices who are providing high-quality, responsive and accessible services, and who are willing to invest to grow their businesses, have nothing to fear from competition.’ 

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