A paper examined the role of primary care trusts in ensuring that local healthcare services were safe, effective, and accessible; and that quality of care in, and patients' experience, of the National Health Service continued to improve. Commissioners needed to play a 'defined and unambiguous leadership role' in improving the quality of care across their local healthcare system.
Source: Commissioning for Quality, NHS Confederation
Links: Paper
Date: 2009-Dec
An article said that pilot walk-in health centres placed near train stations for commuters had low activity levels and high costs. A policy of placing healthcare centres in areas of high worker density might be more successful.
Source: Alicia O'Cathain et al., 'Do walk-in centres for commuters work? A mixed methods evaluation', British Journal of General Practice, Volume 59 Number 569
Links: Abstract | BBC report | Pulse report | Nursing Times report
Date: 2009-Dec
A report said that family doctors should have their contracts rewritten in order to increase incentives for them to work with specialists, pharmacists, and nurses in the commissioning of services.
Source: Judith Smith, Julie Wood and Jo Elias, Beyond Practice-Based Commissioning: The local clinical partnership, Nuffield Trust (020 631 8450) and NHS Alliance
Links: Report | Nuffield Trust press release | NHS Alliance press release | Civitas blog | Pulse report
Date: 2009-Nov
A manifesto was published that called for full accountability for the use of National Health Service resources to be transferred from primary care trusts to family doctors, working in co-operation with local communities.
Source: NAPC Manifesto, National Association of Primary Care
Links: Manifesto | NAPC press release | Pulse report
Date: 2009-Nov
The government announced that the existing system of fixed general practice boundaries would be scrapped within a year, to allow patients to choose to register with any family doctor of their choice. It also indicated that National Health Service organizations had 'preferred provider' status in respect of state-funded healthcare services.
Source: Speech by Andy Burnham MP (Secretary of State for Health), 17 September 2009
Links: BMA press release | Kings Fund press release | TUC press release | CBI press release | Pulse report (1) | Pulse report (2) | BBC report | Guardian report (1) | Guardian report (2) | FT report (1) | FT report (2)
Date: 2009-Sep
A survey (organized by an opposition party MP) found that more than 8 out of 10 primary care trusts were not offering the full three cycles of IVF treatment as recommended by the National Institute for Health and Clinical Excellence, and that there were also widespread variations between regions.
Source: All Your Eggs in One Basket: A comprehensive study into the continuing postcode lottery in IVF provision through the NHS, Grant Shapps MP (grant@shapps.com)
Links: Report | Conservative Party press release | NHS Confederation press release | Telegraph report | Guardian report
Date: 2009-Aug
A study found that the potential longer-term impact of practice-based commissioning on the pattern and delivery of local health services depended upon the extent to which it became integrated with the wider commissioning agenda of primary care trusts.
Source: Anna Coleman, Kath Checkland, Stephen Harrison and George Dowswell, Practice-Based Commissioning: Theory, implementation and outcomes, National Primary Care Research and Development Centre (0161 275 0611)
Links: Report | Pulse report
Date: 2009-Jul
A report by a committee of MPs said that many primary care trusts did not know what they spent on services to address alcohol harms, and across England there was little correlation between need and expenditure. Where services were commissioned there was frequently a lack of performance monitoring and examination of whether what was provided represented value for money.
Source: Reducing Alcohol Harm: Health services in England for alcohol misuse, Forty-seventh Report (Session 2008-09), HC 925, House of Commons Public Accounts Select Committee, TSO (0870 600 5522)
Links: Report | RCP press release | FPH press release | BBC report | Guardian report
Date: 2009-Jul
A survey found that family doctors and practice managers were optimistic about the potential of practice-based commissioning: but that progress was still hampered by a lack of local vision, a lack of clarity over roles and responsibilities, and 'bureaucratic' governance processes.
Source: Julie Wood and Natasha Curry, PBC Two Years On: Moving forward and making a difference?, King's Fund (020 7307 2591) and NHS Alliance
Links: Report
Date: 2009-Jul
The government announced that when the first wave of contracts for 'Independent Treatment Centres' came to an end in 2010, each contract would be reviewed on a case-by-case basis, and new services would be commissioned by the local primary care trust (instead of centrally by the Department of Health) according to whether they met local needs, provided value for money, and benefited patients. Where the National Health Service identified an ongoing need for services, there would be a competitive procurement process: bidders would be invited to deliver services at NHS tariff prices, under the same contract used by NHS providers.
Source: Press release 30 July 2009, Department of Health (020 7210 4850)
Links: DH press release | BMA press release
Date: 2009-Jul
A report criticized primary care trusts for not ensuring that all people living in residential care settings got access to free family doctor services.
Source: Richard Stokes, Postcode Tariff: PCTs and GP retainers in care homes, English Community Care Association (020 7793 4620)
Links: Report | ECCA press release
Date: 2009-Jul
A report said that primary care trusts have noted 'significant changes' in the way they organized patient and public engagement in commissioning, amounting to the 'beginnings of a cultural shift'. But the change in culture might be mainly within the PCTs' own management, rather than something that had impacted on the public or changed the nature of services: the public had yet to have a strong influence on the content of most patient and public engagement strategies.
Source: Patient and Public Engagement: The early impact of World Class Commissioning, Picker Institute Europe (01865 208100)
Links: Report | Picker Institute press release
Date: 2009-Jun
A report examined ways in which primary care trust boards could use commissioning to tackle health inequalities.
Source: The Intelligent Board 2009: Commissioning to reduce inequalities, Dr Foster Ltd (020 7330 0400)
Links: Report | Dr Foster press release
Date: 2009-Jun
The government published an independent report on the future of National Health Service dental services. The report acknowledged the problems that some people had in accessing NHS dental services, and said that the NHS should continue to address specific capacity shortages through the existing dental access programme. It made recommendations on improving the provision of information to patients to help them find an NHS dentist, as well as improving support for NHS dentists.
Source: Jimmy Steele, NHS Dental Services in England, Department of Health (08701 555455)
Links: Report | Summary | Hansard | DH press release | Newcastle University press release | Citizens Advice press release | Guardian report
Date: 2009-Jun
A paper said that existing methods of providing patient information could be increasing health inequalities. Although most patient information was provided in the form of written leaflets or via the internet, around 1 in 5 people did not have basic literacy and struggled to read, and one-third of households did not have a home internet connexion.
Source: Jo Ellins and Shirley McIver, Supporting Patients to Make Informed Choices in Primary Care: What Works?, Health Services Management Centre/University of Birmingham (0121 414 7050)
Links: Paper | Birmingham University press release | Pulse report
Date: 2009-Jun
A think-tank report said that the National Health Service needed to learn from previous reorganizations and not waste the opportunity to modernize community services provided by district nurses, health visitors, physiotherapists, and other staff.
Source: Candace Imison, Shaping PCT Provider Services: The future for community health, King's Fund (020 7307 2591)
Links: Report
Date: 2009-Apr
Researchers examined the complexity of relationships between family doctors, parents, and children in cases where children (about whom there were welfare concerns) and their parents were both patients.
Source: Hilary Tompsett et al., The Child, the Family and the GP: Tensions and conflicts of interest in safeguarding children, Research Report RBX-09-05-ES, Department for Children, Schools and Families (0845 602 2260)
Date: 2009-Apr
An article examined whether larger family doctor practices produced a higher volume and greater diversity of enhanced services. Existing average-sized practices were found to provide similar volume and diversity of enhanced services to those in the largest quartile: there was apparently little merit, therefore, in creating polyclinics or 'supersurgeries' if the aim was to transfer work from secondary to primary care. There did not seem to be an upper threshold above which practice size created spare capacity and expertise to deliver a significantly greater volume or greater diversity of services.
Source: Claire Morgan and Hendrik Beerstecher, 'Practice size and service provision in primary care: an observational study', British Journal of General Practice, Volume 59 Number 560 Links: Abstract | BBC report | Telegraph report | Pulse report
Date: 2009-Mar
A report summarized responses to a consultation on proposals for a new, independent process for reviewing and developing 'Quality and Outcomes Framework' indicators for family doctor practices.
Source: Developing the Quality and Outcomes Framework: Proposals for a new, independent process – Consultation Response and Analysis, Department of Health (08701 555455)
Links: Consultation responses | Consultation document | DH press release | NIHCE press release
Date: 2009-Mar
A report examined how clinicians and health service managers could combine their expertise to bring about improvements in local health services. It set out a series of clear entitlements underlining the support that practice-based commissioners could expect to receive.
Source: Clinical Commissioning: Our vision for practice-based commissioning, Department of Health (08701 555455)
Links: Report | DH press release | Kings Fund press release | NHS Alliance press release
Date: 2009-Mar
An article examined decision-making and the use of economic evaluation at the local healthcare decision-making level in England. Although primary care trusts had been given greater responsibility for priority setting, they lacked the necessary power and understanding of the ways in which long-term solutions to problems in healthcare could be achieved.
Source: Oya Eddama and Joanna Coast, 'Use of economic evaluation in local health care decision-making in England: a qualitative investigation', Health Policy, Volume 89 Issue 3
Links: Abstract
Date: 2009-Mar
The organization representing family doctors said that they should not take part in schemes that offered family doctor practices financial rewards for cutting patient referrals.
Source: GP Referral Incentive Schemes: GPC guidance for GPs and LMCs, British Medical Association (020 7387 4499)
Links: Guidance | BMA press release | Pulse report
Date: 2009-Feb
A report said that primary care trusts could do more to involve the public in helping to decide whether and how to commission new health technologies that had not yet been approved by NICE – by using deliberative processes such as citizens' juries or advisory panels.
Source: Alison Chisholm, Kate Briggs and Janet Askham, Not NICE: Can PCTs engage patients and the public in commissioning new health technologies?, Picker Institute Europe (01865 208100)
Links: Report | Picker Institute press release
Date: 2009-Jan
A report by a committee of MPs criticized the poor quality of management skills within the National Health Service at local (primary care trust) level.
Source: NHS Next Stage Review, First Report (Session 2008-09), HC 53, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report | NHS Confederation press release | RCN press release | BBC report | FT report | Personnel Today report | Guardian report
Date: 2009-Jan
An article compared the policy of fundholding by family doctors during the 1990s with that of practice-based commissioning in the 2000s. The latter policy had addressed the difficulties faced by its predecessor: but it had also incorporated 'significant errors' that jeopardized its potential for success.
Source: Ian Greener and Russell Mannion, 'A realistic evaluation of practice-based commissioning', Policy & Politics, Volume 37 Number 1
Links: Abstract
Date: 2009-Jan
A report highlighted the problems local clinicians were experiencing with the operation of the electronic 'Choose and Book' system for hospital appointments.
Source: Choose and Book: Learning lessons from local experience, British Medical Association (020 7387 4499)
Links: Report | BMA press release | Pulse report | Telegraph report
Date: 2009-Jan
