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PCTs show improvement in annual health check but a slide in excellence

Primary care trusts have improved their overall performance in the 2008-09 annual health check but have slipped back on achieving excellence.

The results published today by the Care Quality Commission show 15 of the 152 assessed scored better on both quality and financial management than last year, while six scored worse.

The regulator said next year it would not measure commissioning arms on core standards, but would focus on commissioning outcomes

No PCTs were rated double weak this year, compared with three last year. But neither were any PCTs rated double excellent.

NHS Salford, which was rated double excellent last year and is the only PCT to have ever attained top marks, scored fair for quality and good for finance this year.

Karl Brookes, a spokesperson for NHS Salford, said: “When you look at the things that matter most to people like cleanliness, being treated with dignity and keeping the public healthy Salford PCT scored 100 per cent. Whilst waiting times and how well services are run in Salford got near top marks too.”

Three PCTs were rated excellent on quality, compared with nine last year. Four were rated weak - Barking and Dagenham, Havering, Redbridge, and Tower Hamlets - compared with eight last year.

PCT Network director David Stout said: “All four of these PCTs are commissioning from two London based acute trusts that are also rated weak and not achieving national targets.”

He added: “It is positive to see PCTs’ performance ratings have improved over the past year. It is clear PCTs are heading in the right direction.”

The CQC said this year’s overall rise in national compliance with core standards was mainly due to PCTs. The compliance rate is the highest it has ever been, at 96 per cent.

This is the first time PCTs’ commissioning and provider arms have been assessed separately on compliance with core standards. The CQC said there had been similar results from both arms in most cases. Commissioners were also measured against national priorities and PCTs’ overall quality scores are based on the assessment of commissioning.

The regulator said next year it would not measure commissioning arms on core standards, but would focus on commissioning outcomes, “without duplicating world class commissioning”.

For example, it said it would be focusing on how well PCTs worked with local authorities on such activities as joint strategic needs assessments.

However, as HSJ reported, the introduction of more demanding Audit Commission based assessments on financial management has been reflected in this year’s scores. No PCT scored excellent for financial management this year.

Continuing improvement for Sheffield

NHS Sheffield chief executive Jan Sobieraj puts his organisation’s continuing improvement in the annual health check down to its “sheer bloody hard work” alongside the “balance of partnerships across the system matched with detailed analysis” .

The primary care trust was created in October 2006 from a merger of North Sheffield PCT, Sheffield South West PCT, Sheffield West PCT and Sheffield South East PCT.

This year, for the first time, it has achieved double good scores, following double fair in 2007-08 and double weak in 2006-07.

In 2007 the trust began a five year strategy called “achieving balanced health”, aimed at reducing health inequalities.

Readers' comments (3)

  • "This is the first time PCTs’ commissioning and provider arms have been assessed separately on compliance with core standards. The CQC said there had been similar results from both arms in most cases."
    What a surprise!
    If PCTs without beds are rated on MRSA (remember, this is based on blood culture) it would be difficult to score highly if the Trusts they fund had major problems!
    Has anyone looked at the change in ratings if the effect of including secondary care last year is removed?

    Unsuitable or offensive?

  • PCT's claim that World Class Commissioning has led to an increase in their 'management costs'. It would appearthat PCT management need extra training in order for them to know how to commission professionaly. Why not recruit true experienced professionals and dispense with overpaid PCT managers without the ability and experience to do the job?

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  • The main problem is that this additional Managment Costs are at the cost of services provided.
    The more management costs in place for world class commissioning means that there are less nursing..... Otherwise known as front line care!
    The other question has to be if Barking, Havering and Redbridge Trust are performing so poorly this has to reflect poorly on the Commissioners. Given that each of these has commissioner teams, what's going on? Oh apparently a new commissioning team has been setup to commission on the behalf of these...... Slightly scarey to know how much this costs!
    We are probably spending as much on commissioning as what we actually spend to run the hospital. If this money was actually being spent on the hospital perhaps we would not have the problems that they are having.... This feels like the conversation what came first the Chicken or the Egg!!!
    If the public ever got wind of how much money is not spent on nursing etc (ie frontline services), compared with everything else. The MPs expenses would look like a drop in the ocean.

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