Equitable access to primary care

The equitable access to primary medical care programme is a major initiative that aims to address the deficiencies in primary care that Lord Darzi identified in his interim report.

Despite sustained investment, access to and quality of services vary significantly across the country, with inequalities in life expectancy, infant mortality and cancer mortality.

The initiative is therefore welcome and timely. Its aims include:

• establishing at least 100 new general practices in the 25 per cent of primary care trusts with the poorest provision;

• establishing one new GP-led health centre in each PCT in easily accessible locations.

PCTs are already a long way through the procurement processes for this initiative. Hempsons has helped strategic health authority and PCT clients give presentations on the procurement process and the alternative provider medical services contract at bidder information events and bidder days.

Initial scepticism

When the initiative was first announced, however, some GPs and pressure groups were sceptical of or even opposed to it. But as time has gone on and prospective providers have come forward, there has been a realisation that the process is happening and that the new services will result in a significant investment in primary care. The concern that no GP providers would be interested has not materialised. However, that is not to say that there are not issues that still need to be considered.

• PCTs need to respond to bidders to ensure they are given the best information, at an early stage, to enable them to match primary care objectives;.

• PCTs must treat all bidders equally to ensure there is no inference of bias or unfair advantage;

• PCTs need to develop good service specifications so they can be clear about what they want to be provided;

• PCTs need to use payment and performance management mechanisms to monitor performance.

Our expectation is that there will be high-quality, innovative bids from all sectors of the primary care provider market by the end of the year. Ultimately, patients will benefit from better access, at convenient locations and times.