Cabinet Office may monitor PCT chief executives

Primary care trust chief executives could have their performance measured under a framework devised by one of the prime minister's chief political advisers, to ensure they can cope with the extra responsibilities their organisations take on next month.

The Office of Public Services Reform, which is part of the Cabinet Office, has been given a brief by prime minister Tony Blair and health secretary Alan Milburn to develop a performance assessment framework to ensure PCT chief executives are of the right calibre to deliver the NHS plan.

Last year the Cabinet Office asked the OPSR - which is led by Wendy Thomson, formerly of the Audit Commission - to assess the structures, powers, incentives, rewards and 'the capacity and capability of PCTs to deliver to their vision'. Its findings were submitted to Mr Blair and Mr Milburn in December.

The work on primary care has been led by OPSR principal adviser Matthew Swindells, formerly director of clinical services at Heatherwood and Wexham Park Hospitals trust.Mr Swindells was not available for comment. It is unclear when the assessment framework will be implemented, or whether it will take the form of an annual compulsory appraisal.

The OPSR, which has a brief to reform and modernise civil service and government, is looking at a range of different approaches to ensure that PCTs deliver the NHS plan. Much of this work is being done by the National Primary and Care Trust Development Programme, part of the NHS Modernisation Agency, NatPaCT operations director Andrew Donald told HSJ.

NatPaCT this week launched an on-line self-assessment tool for PCTs by which they can gauge their own levels of competency and share examples of good practice.

It is also in the process of setting up nine support teams covering two or three strategic health authorities and made up of a PCT chief executive, a PCT chair and a professional executive committee chair. The teams will help shape development programmes and provide a 'reality check' and communications link between networks of PCTs.

Barbara Hakin, chief executive of Bradford South and West primary care trust and national project lead at NatPaCT, said the website framework would give PCTs an 'anchor point' as they prepared for their extended role from April.

She flagged up the complex agenda facing PCTs which would be both commissioning and providing a broad range of services:

'They are charged with revolutionising primary care and effecting change among a workforce whose line-management is not their responsibility.'

And Dr Hakin said it was right that chief executives should undergo assessment, of the sort considered by the OPSR.

'It is the sort of thing that you would expect to see in any good [job] description. I think it is reasonable to expect them to display a range of skills.'

NHS Alliance chair Dr Michael Dixon also welcomed NatPaCT's framework. 'We have been involved in producing the framework. It is all about trying not to be too mechanistic - people should not see it as a weapon of oppression.' But he said he wanted more details about how work led by the Cabinet Office would dovetail with NatPaCT's programme A Cabinet Office spokesperson said the OPSR, in conjunction with the Department of Health and Downing Street, was examining options for a national training plan to ensure that PCTs had adequate skills and authority but that no further details were available.