World class commissioning scores to top charts

Department of Health acting director general for commissioning and system management Gary Belfield told HSJ “a significant chunk” of PCTs have made a “step change improvement” in commissioning over the past 12 months and some were on track to receive the maximum score of 4.

Mr Belfield praised NHS Newham’s work with its local authority and acute trust, and NHS Stoke on Trent for its engagement with local GPs

Speaking ahead of a speech to HSJ’s Fundamentals of Commissioning conference in Birmingham yesterday, he said: “I’m seeing examples now time and again of people who are changing the way services are provided locally [and] commissioning differently. Last year we expected [most] competency scores to be somewhere between 1 and 2… and we pretty much were right.

“I’m expecting this year to see somewhere between 2 and 3. With the better PCTs, I think we’ll see some 3s and some 4s,” he said.

Assurance panel visits started two weeks ago and are due to finish in the third week of May, with the DH expected to publish results by late June.

Mr Belfield identified partnership working, clinical engagement and public engagement as the areas seeing most improvement.

He praised NHS Newham’s work with its local authority and acute trust on maternity services, and NHS Stoke on Trent for its engagement with local GPs.

However, Mr Belfield said he was “frustrated” PCTs were continuing to concentrate on collecting evidence on competencies rather than focusing on strategies, a point he and NHS chief executive Sir David Nicholson both made last year.

He said the process would be adapted for the third year of the programme to reflect this. He would also like to include different levels of assurance scrutiny, after PCT chief executives called for a “lighter touch” process.

Mr Belfield said: “I’d like to be able to move towards a system that recognises the differences in ability and standard.”

But he warned the pressure on commissioners to improve would grow in 2011 and it was vital PCTs and their partners “picked up the pace”.

He said: “We thought it would take three years to really get PCTs up to speed. We just don’t have the luxury now of that third year of slow growth and development because of the economic situation.

“We’ve got about 270 working days now before April 2011 when all the growth monies come to a stop.”