02 November 2007
A flagship government health policy designed to get GPs involved in the design of NHS services is failing to improve patient care, many family doctors believe.
The Department of Health survey of GP attitudes to practice-based commissioning, published on October 29, found doctors believed that they were not getting enough support from NHS primary care trust managers.
Almost a third, 31%, said PBC had not improved patient care, while a further 37% said it was too early to tell. But the majority, 57%, said they still supported the policy.
The policy gives indicative budgets to practices and groups of GPs, enabling them to decide what services should be provided across the NHS. Yet three-quarters of doctors said these budgets had not changed how their practice operated 'very much' or 'at all'.
Most practices, 60%, had not commissioned new services such as hospital clinics as a result of PBC. Doctors were also scathing of the support given to them by PCT managers – 51% rated it as 'poor'.
Almost half the practices surveyed said the quality, format and frequency of information provided by PCTs to help them commission services was poor. Just under half, 43%, had agreed a commissioning plan with their PCT.
Dr Laurence Buckman, chair of the British Medical Association's GP committee, said he was not surprised by the results.
Most PCTs had simply been too slow in getting the policy put in place, he said. 'PCTs just were not geared up for it and the amount of money available for them to do it is very small.'
The NHS Alliance, which represents PCTs and GPs, said there was a 'worrying gap' between manager and doctor perceptions, as PCTs claim to have given 'virtually all' practices an indicative budget.
Spokesman Dr David Jenner said: 'If [managers] continue to maintain the mistaken belief that all is well, PBC will fall apart.'
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