Strategic health authorities will be expected to take ‘full advantage’ of the Department of Health drive to introduce the private sector in commissioning primary care, according to new NHS chief executive David Nicholson.

Strategic health authorities will be expected to take ‘full advantage’ of the Department of Health drive to introduce the private sector in commissioning primary care, according to new NHS chief executive David Nicholson.

This summer the DoH faced controversy after it placed an advert in the Official Journal of the European Unioncalling for private companies to offer their commissioning expertise to primary care trusts.

In an interview with HSJhe said: ‘We have the advert in the OJEUand I would be amazed if most or all the strategic health authorities did not take advantage of that in terms of developing commissioning capacity [among the PCTs in their patch].

‘I expect it to be used across the NHS as a whole. We have to significantly up our game in commissioning in a very short space of time, or else we’ll lose momentum and the provider end of the system will dominate. If that requires people outside the NHS we should do it.

‘But I am completely pragmatic about it; it’s not an ideological attachment to using the private sector.’

Accountability stays

Although he expected SHAs to use private firms to improve commissioning in their areas, he stressed that accountability ‘needs to remain with the PCT’.

Mr Nicholson said the Appeal Court ruling against North East Derbyshire PCT’s deal with United Health Europe ‘makes it more difficult but that’s life. PCTs can’t control their external environment and have to learn to adapt,’ he said.

He also welcomed some PCTs’ desire to hive off provision into separate organisations but cautioned against a hasty and uniform approach. ‘We need to think about why we are doing it. What would be a shame is if a lot of PCTs leapt to do it and created a lot of community trusts. We need to be more imaginative - you don’t have to do it on existing PCT geographies.’

He said that in some areas it would make more sense to shape provision to focus on specific services.

‘PCTs need to think about this rather than just launch into community foundation trusts. I don’t think that would be very helpful.’

  • Primary care trust chief executives deserved better support during the reconfiguration and recruitment process, Mr Nicholson admitted, but defended the number of vacancies that have been left.

He said: ‘Certainly we could have done more as a system to support people. But appointing people who are not up to the job in question at that stage of their career is no way of dealing with it. It’s what support they get over the next few years that matters.’

He said he didn’t agree that the number of existing chief executives appointed so far had been disappointing. ‘The jobs are very tough to do - handling all the things they have to handle, as well as all the relationships.’