Published: 01/12/2005 Volume 115 No. 5984 Page 13

Greater Manchester primary care trusts have established a centralised commissioning and contract business service (CCBS) to support commissioners.

The new service, due to go live in April, will negotiate on price, volume and quality as well as monitor contracts for PCTs and GP practices.

Trafford North and South PCTs chief executive Tim Riley said: 'PCTs and practices will be deciding what is needed. The CCBS will provide an agency to enable contract negotiations to take place.' All 14 PCTs in the Greater Manchester Association of PCTs signed up to develop the new service, which is already running in shadow form.

Greater Manchester strategic health authority's submission on PCT mergers - which proposes a reduction from 14 to 10 PCTs - stresses the role of the new service in strengthening commissioning.

Dr Riley said the service draws on private sector experience, with the model emerging after PCT chief executives carried out work on refining commissioning.

'One of the overriding things to emerge from our look at systems in Europe and America was the need for a far more actuarial approach to services, ' said Dr Riley.

He added: 'We need to set in place real contracts rather than arbitrary things called service-level agreements, and we need to monitor them on volume, activity and utilisation.' Dr Riley gave the example of a GP practice wishing to commission hip replacements for its population. 'The CCBS would provide specifications for the contract and source it, then do the monitoring. This would provide GPs with a far more responsive information system to find out what is actually happening to patients.' The CCBS is being urged to buy services for the integrated clinical assessment and treatment services (ICATS) development in south Manchester, in which GPs can use choose and book to refer patients straight into the diagnostics stage of an investigation at a specialised centre in Withington Community Hospital.

Business modelling is under way, said Dr Riley, and this may include inviting partners to provide functions. He said: 'The organisational model has not yet been finalised.

PCT boards will be given options on public and private sector models.' He stressed that this was significantly different to the controversial move in Oxfordshire to outsource all commissioning as PCTs would maintain the crucial element of deciding what services to commission, looking to the CCBS for support. 'PCTs are statutory bodies and have to be the contracting agent, ' he said.