Providing FHS administrative services is part of primary care trusts’ role and includes maintaining contractor performer lists, paying primary care contractors, maintaining population databases and administrating screening programmes. Many PCTs use shared service arrangements to deliver these services.

This work is often been seen as low profile and has suffered a lack of investment and leadership. Service quality and performance varies, leading to difficulties in comparing services to identify best practice. There has been no national network to consider service standards, quality measures and performance.

With the need to make significant cost savings while maintaining quality and avoiding increased risk, I arranged a FHS seminar on providing cost-effective quality FHS services. Pockets of excellence were believed to exist in PCTs or shared services; if these could be identified and highlighted then everyone could move to the best standards. This, in turn, would enable cost reductions to be delivered in a way which could increase quality without adversely affecting risk.

Attendance exceeded expectations with 82 attendees representing FHS service delivery to 122 (80 per cent) PCTs. A directory has been compiled of PCTs, FHS service providers and internal auditors and this will be developed to include “host” and “external auditor”. This has potential use with third-party assurance, hosting and governance arrangements.

The day was structured with three speakers in the morning and group discussions in the afternoon building on the theme of cost-effective services. The speakers covered:

  • Quality in FHS Services as defined by internal audit
  • Developments to the National Health Application and Infrastructure Services system
  • Benchmarking in FHS services.

The benchmarking session proved its potential and resulted in agreement to undertake a national exercise to enable cost comparisons to be made and to open up dialogue where good practices are evident.

The afternoon group sessions considered best practice in the each of the services. The key performance and activity indicators developed and used by LaSCA were discussed and both quality measures and key controls were also considered.

Back office type services are about high-quality delivery, value for money and low risk and the theme of the day was around providing these services in the current climate of 15 per cent savings. The day proved invaluable in helping us take this challenge forward.

Tangible outputs
Availability of a national benchmarking exercise
Directory of FHS providers, PCTs, internal auditors
Good practices for each FHS service
A set of KPIs / KAIs to be tested out by attendees;
Web page www.lasca.nhs and ideas for content
Contact list / Evaluation report 


Softer outputs
Networking and relationship building
Increased profile of FHS administration
Personal development of attendees
Ideas for attendees to check out in own organisations
Stronger links with internal audit
Increased appreciation of key controls and links to risk


Future work
Feedback on the benchmarking
Feedback on  / refinement of  KPIs and KAIs
Development of quality measures and key controls
Potential Information provision for PCT commissioners
Develop directory to include ‘host’ and ‘external auditor’
Third party assurance and governance


For details including participation in the benchmarking exercise visit