Furious primary care trust chiefs have lambasted the Audit Commission after being marked down in annual reports on the basis of world class commissioning scores. They had been told they would not be judged on the measures.
Up to a third of PCTs have had statements added to their annual governance reports highlighting “weakness in commissioning arrangements” on the back of their results in six competencies (see box).
Hull PCT chief executive Chris Long said the step “discredited Department of Health policy”.
He said: “I’m absolutely flabbergasted. The rationale was ‘you might have passed all your audit tests and used your resources well but you must be crap commissioners because world class commissioning says so.
“This was supposed to be a developmental period – year one was about taking the baseline and all at once we’re being judged on it.”
PCT Network director David Stout said the Audit Commission had been “way too mechanistic” in its approach.
He said: “PCTs that are probably better than they were last year are getting caveats [on their reports] which they didn’t last year.
“There appears to be no appeal process so you’re stuck with it – if that’s the judgement they’ve reached it’s a done deal. But it’s unhelpful because it could be misinterpreted.”
Andy McKeon, managing director, health, for the Audit Commission, said it had agreed with the DH and Healthcare Commission that auditors would not assess and score the commissioning and procurement “key line of enquiry” for their use of resources assessments in 2008-09, but that auditors still needed to meet their statutory responsibilities.
They would do this by relying on work done as part of world class commissioning and its results, which he said “broadly correlated with the relevant key line of enquiry”.
“This was considered to be the simplest, most efficient, most consistent and least burdensome approach while at the same time enabling auditors to fulfil their statutory responsibilities.”
Mr McKeon said auditors had been “substantially guided” by PCTs’ world class commissioning results.
He said they had “applied judgement according to individual circumstances”, for example where a PCT had made progress since then.
“It has no impact on PCTs’ use of resources scores or the comprehensive area assessment,” he said.
A DH spokesperson said: “The DH and the Audit Commission are working closely together so that our systems are more aligned and bring more consistent results.”
The commission said once alignment had been reached full details of the changes to both systems of assurance would be given to PCTs.
The six competencies in the argument
The six competencies the Audit Commission used to measure PCTs’ performance:
- Competency two: work collaboratively with community partners
- Competency three: engage with public and patients
- Competency five: manage knowledge and assess needs
- Competency six: prioritise investment
- Competency seven: stimulate the market
- Competency nine: secure procurement skills