Published: 17/03/2005, Volume II5, No. 5947 Page 5

A new initiative that would give primary care trusts a better handle on financial risk and cut bureaucracy by farming out work to a freestanding contract management service - either within the NHS or outside - has been praised by Sir Nigel Crisp (see above).

Hambleton and Richmondshire PCT chief executive Simon Kirk is leading a pilot scheme that is inviting bidders to run local commissioning on behalf of 10 PCTs in north-east Yorkshire and north Lincolnshire.

Mr Kirk said PCTs are faced with the task of purchasing sufficient capacity to enable patient choice while working within the constraints of payment by results and guarding against wasteful duplication of actions.

'It seems unlikely that the current capacity of PCTs to undertake these functions - mainly on a one-to-one basis (that is, one PCT to one NHS trust) - will be able to meet the more complex task.

'PCTs must be able to deliver over a range of providers within an agreed time frame without wasteful overcommissioning through risk-aversion.'

And he said the likely imperatives arising from the Gershon review, which calls for greater efficiency in government bureaucracy, 'will render the concept of 300-odd PCTs each providing inhouse service indefensible'.

The PCTs are inviting bidders from inside or outside the NHS.

'It would be a separate service provided either with each of the PCTs holding a contract for service or the equivalent of a company in which each of the PCTs would be a shareholder and represented on the board, ' he said.