Supported by Capita Advisory Services

Judges

  • Edna Robinson, national lead, NHS Networks
  • Mike Farrar, chief executive, NHS North West
  • Andy McKeon, managing director, health, Audit Commission
  • Dr Cynthia Bower, chief executive, NHS West Midlands
  • Neil Griffiths, director of health, Capita Advisory Services

Winner Oldham PCT

Oldham PCT has proved an excellent all-round performer and an organisation not afraid to break new ground. For the judges, the quality of management, from the top down, simply outshone the rest

Oldham primary care trust is making strides in many areas including public health, care for people with long-term conditions, and patients' access to healthcare. It prides itself on ambition and willingness to work in new ways with a range of partners, and statistics show this approach is having an impact.

Of all the PCTs it put the strongest emphasis on commissioning. It also had an enormously strong management team that showed a real grasp of what PCTs will be in the future.

But until recently, Oldham was the 38th most deprived area in England. It has since bucked regional trends and fallen to 43rd. The PCT is involved in leading three national initiatives that it believes will meet local needs. It is looking at ways to cut waiting times to a maximum 18 weeks; it is one of three piloting a cancer family history service to help people who might be at risk; and it claims to be the first in the country to offer patients the option of some routine tests in pharmacies.

The PCT's commitment to partnership is exemplified in its public health work. It is running a wide range of community schemes, working closely with Oldham borough council, aided by joint public health posts. For example, the Up Your Street initiative sees trained advisers help people with diabetes, weight problems and osteoporosis to get the right exercise.

In 2005-06, 1,800 people quit smoking with the PCT's help. This included some teenagers after specialist support workers ran courses in a secondary school. Death rates from circulatory disease and cancer are decreasing. Teenage conceptions are also falling thanks to better access to emergency contraception, outreach services and expert advice.

There has been a£1.2m investment in mental health, including a multi-agency older people's mental health team and two new community health workers to work specifically with black and minority ethnic groups.

One in six adults in Oldham has a long-term condition. The PCT is a partner in a unique care project with GPs, pharmacists, patients, social services, and Pennine Acute Hospitals trust, to reduce emergency admissions for over-65s.

This has grown into a team of eight community matrons seeing 600 patients. Hospital admissions have dropped and patients' quality of life has improved. The PCT is also helping local people into NHS employment. Its Cottoning On team runs a supported application process for young people and those from black and minority ethnic communities.

Staff satisfaction is high and the PCT is constantly seeking new ways to ensure patients have a say in how services are run. Its walk-in centre, for example, is open all year round and sees 1,000 people each week. Patient and public involvement groups were involved in assessing this.

The PCT had a small surplus in 2005-06 and has had no unplanned borrowings for three years, and it scored well above average in the ALERT process to assess value for money.

Judges' reflections

Brave effort

In the current healthcare climate, and with performance targets, ratings and fitness reviews, all the entrants deserve awards for being brave and confident enough to throw their hat in the ring.

The judges' role was to differentiate the outstanding from the impressive. Shortlisting the submissions at first appeared a formidable task, but successful entrants ensured that they covered all the key criteria.

Key features in the most outstanding organisations included practitioners who were able to speak to the judges informally; demonstrating a genuine enthusiasm for improvement; inclusion of clinicians in multi-professional groups for discussion; the chief executive's infectious enthusiasm; and people speaking about challenges as well as achievements.

My lasting memory is that the word 'impressive' soon becomes inadequate in describing the real commitment to improving services to patients that exists in all the organisations we visited.

Neil Griffiths is director of health at Capita Advisory Services.

Highly commended Walsall teaching PCT

Walsall teaching PCT is no stranger to innovation and the positive results are there for all to see

Buses, beer mats and mobile phones - all are used by Walsall teaching PCT to push public health messages. It is that kind of creativity that has helped the trust transform its performance during 2005-06.

The PCT made rapid progress in a busy year, which saw it revamp services for older people, achieve a good financial position, and implement innovative community schemes. It has performed particularly well around access to GP services.

Another achievement has been a dramatic improvement in implementing choose and book. The trust went from 196th in the UK in February this year to 17th by July. The PCT and its partners have seen a huge drop in teenage pregnancy and the trust has sought new ways to tackle other areas of public health, including a campaign on binge drinking.

For 2006-07, the PCT has agreed a sponsorship deal with Walsall Football Club to reach 1 million visitors with public health messages. It includes a pioneering text service, which allows people to sign up for free health messages for a year.

Obesity is another area where the PCT is leading the way. It has completed a joint pilot with education to gather information on children's height and weight measurements and subsequent recommendations went out to all schools.

Finalist Tower Hamlets PCT

Tower Hamlets PCT is successfully working to improve the health of many of the London borough's fast-growing and diverse population, from teeth to feet

Tower Hamlets PCT's mobile dental unit, which has helped hundreds access good care, is just one example of the trust's innovative approach.

The financially stable PCT moved from no stars to two stars in last year's ratings - the only inner city PCT to make that leap - and it met all performance targets and the core standards of the first annual healthcheck for 2005-06.

Other achievements include a sharp decrease in heart disease, well ahead of targets, and a steady increase in life expectancy over the past few years. Initiatives like 'sex text', which enables young people to get advice, have via their mobile phones, have contributed to the best performance on sexual health in London. The PCT has also reduced teenage pregnancies by a quarter, the strongest performance of all neighbourhood renewal areas.

Its Improving Health and Well-being strategy was developed through extensive consultation, including tailored workshops and four open events, and it has worked with health service partners to establish a patient panel.

Finalist East Lancashire PCT

From targets to financial turnaround, Burnley, Pendle and Rossendale PCT - recently part of a merger to form East Lancashire PCT - was on a mission to be the best

As turnarounds go, it is quite a story. The trust went from one star in 2003-04 to three stars in 2004-05. And it retained three stars in 2005-06. Strong corporate management has moved it from an organisation saddled with recurrent deficits to one with a£6m surplus at March 2006.

It has worked with partners including social care, education, housing and leisure, and the voluntary and independent sectors to tackle health deprivation and provide the right services.

For example, it has established a strategic partnership board with core representatives from the PCT and Lancashire county council. One of its successes is a multi-agency assessment team for children and young people in Rossendale. It is also working in partnership to improve public health, including working via a local area agreement. Alcohol problems are being tackled by a joint plan with the police.

The trust is tackling teenage pregnancy with schemes in all three boroughs, working with teachers to deliver relationships education and offering sexual health services in 'young-person friendly' places.

Genuine involvement of local people is central to the PCT's ethos. One example is the St Peter's patient group, which is advising on the development of a new£29m integrated health and leisure centre in central Burnley.

Finalist Birmingham East and North PCT

Merger was no obstacle to innovation and improvement in Birmingham, where the restructuring proved a catalyst for progress

Birmingham Eastern and Birmingham North PCTs merged in October and set goals including zero waiting times and improving public health to the extent that local people live 10 years longer. The new PCT has gone on to become a strong performer and innovator in many aspects of healthcare, forging good partnerships and getting results.

Its work with acute trusts means it now has some of the shortest waiting lists in the country, and it has hit access targets despite more than half of its GP practices consisting of a lone GP. The PCTs have worked within the neighbourhood renewal agenda and developed 'floor target action plans' with the city council, focusing on improving male life expectancy and tackling infant mortality, and releasing an extra£12m for health, housing and unemployment. They have also raised awareness of key ward-level health problems and developed specific ways of tackling health inequalities in different areas, including bhangra dancing exercise classes.

It is leading the way in joint working around intermediate care and learning disabilities and the management of long-term conditions, including the establishment of a Partners in Health centre offering a wide range of clinics. The PCT has also taken innovative steps in leadership and staffing, including employing the first consultant dietician in the country, and developing a mentoring and peer support system for all existing and newly qualified GPs.