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PCT reorganisation is bad for your health, says NHS Alliance

19 October 2007

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Responding to the Healthcare Commission’s announcement of NHS performance ratings for 2006/07, the NHS Alliance  says this confirms the view of many frontline staff: that “reorganisation is bad for your health”.

The Commission’s report, says NHS Alliance, emphasises distinct differences in both quality of services and use of resources between those PCTs that were reorganised last year and those that were not.

In a press statement, the NHS Alliance says: “It is “not surprising that most of those in the first group have scored ‘fair’ or ‘weak’. Should any future government ever consider a similar reorganisation, they should read this report first.

“There is also a fundamental problem for PCTs in that they are scored on achieving national targets such as Choose and Book where they are not responsible for delivery.

“The Commission acknowledges there have been technical difficulties with the system, while it is GPs – not PCTs – who deliver the scheme. Opinions remain divided as to its value among clinicians and patients.

“Despite these problems, it is pleasing to see some impressive successes, such as Barking and Dagenham PCT, who have jumped from a ‘fair’ to an ‘excellent’ rating for use of resources in just one year.”

NHS Alliance chairman Dr Michael Dixon says: “PCTs have a particularly complex task that needs to be better understood than is currently the case. Their services depend upon the performance of other organisations, ranging from foundation trusts to independent treatment centres to individual GP practices.

“Depending upon the PCT size, there may be 50 or more different organisations that contribute to their performance rating. Nor can PCT management rely on issuing directions to staff in the same way as the other sectors. Frontline staff are often not employed by the PCT.

“Success in PCTs requires a quite different approach from senior management and boards. Skills in negotiating and persuasion, and genuine engagement with clinicians, are critical in primary care.

It would be useful if, in future, the Healthcare Commission could look at clinician engagement in particular as part of its performance rating of PCTs.”

NHS Alliance