The majority of primary care trust managers believe they cannot achieve top scores for their commissioning without outside help, according to research by the King’s Fund.

Two thirds of PCT chief executives or directors of commissioning responding to a King’s Fund survey said they did not feel able to attain the top level 4 score in the world class commissioning assurance process without using external support from providers such as management consultants or strategic health authorities.

More than two thirds said it would not be possible to reach level 4 world class commissioning without some form of external support

Speaking at the HSJ Managing Long Term Conditions conference in Harrogate last week, King’s Fund senior fellow Nick Goodwin explained that the survey was part a larger review of the role of external support to commissioners. Researchers asked PCTs their world class commissioning score prospects without external support.

Mr Goodwin said: “More than two thirds said it would not be possible to reach level 4 world class commissioning without some form of external support.”

According to the survey, the four most common forms of support used by PCTs were: adding staffing capacity to carry out commissioning, providing tools to help with areas such as data analysis, help with strategy development, and advice on giving good presentations during the assurance process itself.

Despite this fresh evidence of a lack of confidence at PCT level, Mr Goodwin defended PCT commissioning against last month’s critical report by the Commons health committee. Mr Goodwin said that report had been “unfair”.

He said: “It was a very damning verdict altogether from the centre. It’s a common perception, particularly in London and Whitehall, that commissioning is weak and ineffective.

“I think that’s been the perception for quite some time. I think this is a little unfair actually. Commissioners locally have done an awful lot, particularly in the area of primary and community care, in terms of such things as managing structures, prescribing, and clinical governance.”

Mr Goodwin told delegates commissioning was “probably under resourced”, and suggested PCTs lacked enough staff to work on lower levels of the process.

“PCTs [are] incredibly top heavy in terms of seniority,” he said.