Handing commissioning control to clinicians but maintaining primary care trusts to support them would be the “dream ticket”, rather than abolition, according to a chief executive pioneering the idea.
Two consortia were handed control of around a quarter of NHS Cambridgeshire’s £870m budget last week. They will decide commissioning in their areas for all services, except those covered by specialised commissioning arrangements.
PCTs are being abolished in 2013 but what we’re planning on doing is handing over the PCT to the consortia and we’re reaching a point where we’ll do that soon
The Hunts Health consortium comprises 10 practices while the Borderline Commissioning Consortium at present includes four practices.
The PCT, as the statutory body responsible for providing services, will still have to ensure care needs are met until the government changes legislation.
However, chief executive Paul Zollinger-Read said the PCT would be “handed over” before then to consortia to provide support while continuing to commission services for populations not covered by a consortium.
He said: “PCTs are being abolished in 2013 but what we’re planning on doing is handing over the PCT to the consortia and we’re reaching a point where we’ll do that soon. We will then have the dream ticket, the expertise of GPs and the clinically led commissioning, with real expertise of NHS management.”
Consortium lead GP Dr Simon Brown said he still looked on the PCT as the “safety net” and its abolition from 2013 would represent “another throwing up of the cards”.
NHS Cambridgeshire started working towards the creation of GP commissioning consortia last year, as part of regional plans to improve efficiency and reduce spending - in particular to stem a continuing growth in unscheduled admissions.
Based on September board papers, the PCT is forecasting a year-end underspend of £482,000, having started this financial year with a historic debt of £26m.
The PCT will review the performance of the two pilot consortia after 12 months and expects four more to form over a series of phased roll outs, though membership is not mandatory.
NHS Cambridgeshire director of strategy Andy Vowles said he expected to have 50 per cent of practices involved in consortia by next April but this could be “ramped up” by the impact of the white paper.
He said: “We’ve got practices that initially didn’t want to get involved, saying actually we think we do.”
However he told HSJ he expected a handful of practices to remain outside, either through their own choice or because consortia “aren’t necessarily that keen to have them”.
The PCT has developed a human resources framework for consortia with law firm Mills and Reeve, which sets out the pros and cons of different employment models for consortia to choose from.
Mr Vowles said: “Most consortia seem to prefer a secondment model, where our staff are still employed by the PCT bit are line managed by the cluster.”
NHS Cumbria has a similarly advanced programme involving six GP led commissioning consortia.