PCT managers warn GPs over commissioning pitfalls

Taking full responsibility for commissioning will expose GPs to a far more complex set of challenges than practice-based commissioning, senior PCT staff have warned.

Andrew Lansley: PCTs are failing to achieve the required outcomes and quality through commissioning
Andrew Lansley: PCTs are failing to achieve the required outcomes and quality through commissioning

Managers say GPs must beware the knock-on effects of spending decisions, and withstand pressure to spend heavily in the first six months of the financial year.

Close relationships with hospital colleagues will also be vital to their success as commissioners, PCT managers say.

Health secretary Andrew Lansley has said PCTs failed to achieve the required outcomes and quality through commissioning. But successful PCT commissioners would be useful to GP consortia, he said.

PCT managers that spoke to GP said they hoped to support GPs during the transition and once consortia are established.

Tony Ullman, associate director of NHS Manchester's central commissioning hub, said GPs would need help to get commissioning right.

'GPs sometimes get frustrated by the pace of change with some aspects of PCT work,'

Mr Ullman said. 'But, (commissioning) is often more complex than GP commissioners have been exposed to. Setting up a new service can pose a risk somewhere else, you need to understand the whole system.'

He called for a 'collaborative approach' with the acute sector, but added: 'Be as strong as you can about contracting with acute hospitals.

'It's not just about what you agree, but how you manage demand and activity and monitor what is happening so you only pay what you have to pay for.'

John Parks, chief executive of NHS Northamptonshire, added: 'In the first six months, it is really easy to spend money. Once you have lost a grip on the money it is quite difficult to get back in a balanced position.'

Mr Parks said GPs should move from a 'spending regime' to an 'investment regime'.

He said: 'GPs need to understand where they are getting the greatest return for each decision made and understand the resource implications of those decisions.

'Understanding that will be done by really good consortia.'

  • Work collaboratively with hospital colleagues.
  • Check bills and validate hospital activity.
  • Be cohesive as consortia to ensure there are no outliers.
  • Keep a grip on budgets.
  • Beware knock-on effects of spending decisions.

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