Published: 15/09/2005, Volume II5, No. 5973 Page 5
The health secretary's policy adviser is to hold an emergency summit with primary care trust chairs today amid fears that the rush to reconfigure PCTs will damage patient care and 'leave staff in a vacuum', HSJ has learned.
The meeting with Matthew Swindells, which will be attended by about 10 members of the NHS Confederation PCT chairs forum, follows an outspoken public attack on the government's approach to reorganising PCTs by NHS Appointments Commission chair Sir William Wells.
Addressing an audience of trust board members at a confederation conference last week, Sir William described the approach laid out in NHS chief executive Sir Nigel Crisp's July policy paper Commissioning a Patient-led NHS as 'totally unsatisfactory' and a 'ridiculous way to expect people to conduct business'.
Sir William accused the government of 'political smoke and mirrors' and said the policy offered 'no clarity whatsoever for the future of primary care trusts or the role of boards'.
Commissioning a Patient-led NHS says strategic health authorities do not need to look at how boards operate until after the reconfiguration has been agreed. 'This second stage will focus on internal capacity and capability to discharge new functions, and particularly on leadership ability, ' it says. 'It will be as rigorous as that for NHS trusts applying for foundation trust status where strengthening the composition of boards and improving governance systems have featured strongly.' Sir William said that until there was more clarification 'on the roles and responsibilities of boards' from the centre, the NHS Appointments Commission, which appoints NHS non-executive directors, was 'not prepared to start on this change', adding that it was 'not fair to the people sitting on board tables to be expected to change' until there was an explanation of their new positions.
Sir William has held two meetings with NHS chief executive Sir Nigel Crisp in the past week to discuss his concerns.
Today's meeting between chairs and Mr Swindells is designed to make a strong start to achieving that clarity, according to Tony Hughes, co-chair of the NHS Confederation PCT chairs forum.
Mr Hughes, who is also chair of Mansfield district PCT, told HSJ he will want to 'find a way forward' at the meeting. 'We do not want to be obstructive, but [boards] have a range of commitments in terms of patients and staff, and we want to make sure this process is handled properly and not rushed, ' he said.
'We want to avoid another situation such as when PCTs were created, then area health authorities were dissolved soon after. PCTs had no clue that was going to happen and it had a negative impact for the first 18 months to two years on some because they had to pick up deficits they didn't know they would have to manage.
'There are significant deficits in the system now, and we need to be clear how they are going to be managed in the new world. If boards are taking on new functions, they also have to assume responsibility for what currently exists. It is that kind of clarity that has not been delivered, ' he said A spokesperson for the DoH said: 'Local NHS organisations will drive the shape and structure of their organisation. Where proposed changes involve possible changes to employment and staff, their representatives and relevant bodies will be fully involved in the local consultation process.' The chairs' move to highlight concerns follow HSJ's revelations that many PCT chief executives feel the approach to reconfiguration is 'rushed', incoherent', 'vague' and 'political' (news, pages 5-9, 8 September).
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