Practice-based commissioning finally picking up pace

26 Jan 09 - Pulse

By Gareth Iacobucci

The Government’s flagship practice-based commissioning scheme is finally showing signs of creaking into life, a Pulse investigation reveals. Data obtained under the Freedom of Information Act shows a more than 10-fold increase in new services commissioned over the last two years. Pulse’s figures are the first to be collected on the number of new projects spawned by PBC since its launch in 2004 – the Department of Health only tracks the cumulative number of practices that have commissioned a single service. And the new findings suggest rumours of the demise of the policy may have been exaggerated. Back in 2006, PBC was virtually moribund, with the 33 PCTs that provided details to Pulse having approved or launched just 34 new services through the scheme. But over the last two years there has been a dramatic increase in activity, up to 247 services in 2007 and 394 in 2008, even as a succession of key policy analysts have declared the scheme virtually dead and buried. Examples of services commissioned through PBC included ones for community dermatology, diabetes, musculoskeletal triage, ENT and nerve conduction testing.

The most active areas in terms of new services commissioned were Kirklees, Oxfordshire, Lincolnshire, South Birmingham, and Heart of Birmingham. Dr Gurkirit Kalkat, a GP in Barking and PBC cluster lead for Barking and Dagenham, said there was ‘a lot more happening’ in his area. ‘In the first two years, it was a bit difficult to being ideas out, but in the last year, PCTs are helping us a lot more.’

Dr Paresh Dawda, GP in Bishop’s Stortford, Herts, said: ‘Uptake is beginning to increase and it's encouraging to see the data reflect this. But there is a lot more work to be done - we’ve only really touched the tip of the iceberg.' Some trusts are still struggling to get PBC off the starting grid. Brent PCT commissioned no new services through PBC between 2006 and 2008, while Bassetlaw PCT and Camden PCT commissioned just three services each. Dr Johnny Marshall, chair of the National Association of Primary Care, responded cautiously to the new figures, although he did say there was progress in some areas: ‘Some of our members are still concerned it is PCTs leading the process.’

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