PCT mergers bring end to uncertainty
pharmafile | May 30, 2006 | News story | |Â Â Â
The number of Primary Care Trusts in England is to be cut in half from 303 to just 152, the government has confirmed, bringing months of uncertainty to an end.
Rumours about possible mergers began circulating more than a year ago, and PCT staff have been awaiting a verdict on their organisations, and their own jobs, since late 2005.
The mergers will create much larger PCTs, which the government hopes will be more efficient and more effective in creating a patient-centred NHS and overseeing a number of radical reforms to the health service.
The first wave of PCTs were created in 2002, and the government had hoped the new kind of locally focused NHS trust could be the driving force for reform in the health service, but the Department of Health became frustrated with the slow pace of change, with many PCTs struggling to improve patient care through commissioning re-designed services.
The government now hopes that two newer initiatives Payments by Results (PbR) and Practice-Based Commissioning (PBC) can perform this function, and it now expects PCTs to take on a more strategic role.
PCTs will still play an important role in commissioning services, but will be charged with co-ordinating the work done by clusters of general practices engaged in Practice-Based Commissioning.
Having handed greater power to primary care practices, there is less emphasis on PCTs engaging locally, and the government has sought mergers to gain the greater economies of scale.
Announcing the changes, Health Secretary Patricia Hewitt said: "The new PCTs will be better organised to commission services that best suit the needs of their local population.
"These changes will also put more power into the hands of GPs and other frontline NHS staff and give them a greater say how services can be delivered around the needs of their patients."
One major advantage promised by the re-organisation is closer working between the NHS and social services.
Around 70% of the new PCTs will mirror local authority boundaries, which the government hopes will bring about more seamless health and social care and avoid unnecessary duplication.
Responding to the news, key health service organisations, the NHS Alliance and the NHS Confederation, both expressed their relief that the merger decisions had finally been announced.
The NHS Alliance said it welcomed the end to conjecture and the instability that has brought, with chairman Dr Michael Dixon adding: "What matters now is that there is smooth handover to the new PCTs and that individual PCT staff members are treated fairly and reasonably. That is essential if we are not to lose momentum in implementing practice-based commissioning and other NHS reforms.
"The new PCTs will have to hit the ground running in October, so the next few months are critical.
"Most importantly, they have to build relationships of trust with their local clinicians. That is not going to be easy for those that cover large geographic areas. Strategic clinical leadership is the key.
"We all want to get on with the job of improving patient care and creating a primary care-led NHS. The Alliance, as always, will support the new PCTs in their vital role."
