9 March 2011
Skilled management will be needed to ensure the move to GP commissioning does not affect the quality of health and social care, the Nuffield Trust warned today.
The health policy charity said primary care
trusts faced real-terms cuts of between 0.3% and 2.5% in 2011/12 as a result of
inflation and the requirement to lodge 2% of their allocations with strategic
health authorities.
The trusts would have to manage these cuts in the throes of the move to GP commissioning and the role of PCT clusters would ‘be critical and extensive’ in this, the report said.
The clusters are intended to improve service quality, initially on behalf of GP consortiums and then, after 2013, in partnership with them. The report noted that there was ‘a hint in the Operating Framework [for the NHS] that PCT clusters may be retained by the NHS Commissioning Board as a form of local outpost and development agency’ for the consortiums.
It added that the clusters needed reassurance about their future after 2013 if they were to retain staff and meet performance targets, or they might merely ‘keep a grip on the system’.
Nuffield Trust policy head Judith Smith said past restructurings had failed to provide the promised benefits because organisations focused on finance rather than on staff support and care quality.
‘The Operating Framework understandably emphasises financial and organisational aspects of reform and performance,’ she said.
‘But it is critical that staff, in particular managers, are supported adequately to make the reforms work.’
The trust has also issued results from polls on the NHS reforms taken among GPs and the public.
These found that only 23% of doctors felt the change to GP commissioning would improve patient care and half expected a major effect on the viability of their local hospital.
However, 56% of the public favoured ‘fundamental reform’ of the NHS.
Public opinion split evenly on whether NHS care quality had improved or not over the past three years and a slight majority was indifferent about whether care was provided by public or private organisations as long as it was free of charge.
