'Universal PBC coverage' reported by 20% of SHAs

One strategic health authority (SHA) in five has achieved 'universal coverage' of practice-based commissioning (PBC) and the rest will have done so by the end of the year, according to data submitted to the DoH.

An Audit Commission report released this week stated SHAs had told the DoH they were on track to meet a target to have all practices involved by December.

Universal coverage is defined as 'having put in place arrangements to facilitate practices becoming practice-based commissioners'. This means providing detailed information about clinical and financial activity, payment under the directed enhanced service (DES) and governance support.

The data supports the findings of a GP survey, which found one in five GPs had received an indicative budget and 42 per cent were involved in commissioning (GP, 9 June ).

A DoH spokesman said most PCTs were on course for universal coverage by the autumn.

GPC negotiator Dr Richard Vautrey said: 'It's another false target. SHAs can report back that they have full engagement, but the situation on the ground is very different.'

Progress against the target for universal coverage will be measured using payments made under the commissioning DES.

The Audit Commission report, 'Early Lessons in Implementing Practice Based Commissioning', warned that this 'could skew the national picture if not carefully interpreted'.

The report stated that the initial DES payment is made on the basis of the practice signing up, whereas genuine engagement requires practices actively to be managing budgets.

The report warned there was no guarantee it would produce savings, and that there was 'a tendency to assume a primary-care-based solution is more cost effective, which will not always be the case'.

Audit Commission managing director for health Andy McKeon told GP: 'PBC can ensure resources are used effectively, but it's vital to do the maths to ensure cost-effectiveness.'

nick.bostock@haynet.com.

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