Media Archive 2007

Practice based commissioning (PBC) is a key reform for the NHS. It is also an important focus of the Audit Commission's local audit work and national studies on financial management in the NHS. A short booklet was published in June 2006 , Early Lessons in Implementing Practice Based Commissioning, which covered high-level issues associated with implementing PBC. This was the first in a series of products that the Commission intends to produce on PBC to monitor and support its implementation.

Building on Early Lessons, the Commission plans to publish a further national report on PBC in autumn 2007. It will assess whether PBC is enabling PCTs to better manage their financial risk and will support the effective implementation of the financial management aspects of PBC locally. The main sources of evidence will be drawn from fieldwork visits to a sample of PCTs and their GP practices across England, a survey of practices, and our local audit work.

The GP survey has been designed to collect further evidence from a practice perspective on PBC policy and implementation, as it was not feasible to visit every practice in each PCT. It is being targeted at approximately 50 per cent of practices in our sample set of sixteen PCTs (in England) involved in the national study. These PCTs are:

1. Bristol Teaching PCT
2. Berkshire West PCT
3. Central Lancashire PCT
4. County Durham PCT
5. Leicester City PCT
6. Liverpool PCT
7. North Bradford & Airedale PCT
8. North East Lincolnshire PCT
9. North Yorkshire and York PCT
10. Nottingham City PCT
11. Stockport PCT
12. Sutton & Merton PCT
13. Tameside & Glossop PCT
14. Walsall PCT
15. Warwickshire PCT
16. West Sussex PCT

Your practice may have received an invitation from the Audit Commission to complete a survey in the last few weeks.  It would be extremely helpful if practices could contribute to the study by completing this survey, as it is extremely important to obtain the practice perspective of PBC.

Only one response is required per practice, and survey data used in the report will be anonymised, unless your permission is obtained to use any notable practice information provided, it should take no longer than 45 minutes to complete.

Any questions about this survey or the national study should be directed at Rajesh Kishan on (020) 7166 2744, or else by email at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

Do you feel pharmaceutical companies act ethically in their dealings with you?

The ABPI Code of Practice for the Pharmaceutical Industry regulates the promotion of medicines for prescribing to health professionals and sets out exactly how pharmaceutical companies are allowed to interact with you.  The Code reflects and extends beyond UK law and many of the requirements of the Code, in particular those relating to hospitality, meetings and gifts are mirrored in health professional codes. The NAPC has been running monthly articles about the requirements of the ABPI Code since January which can be viewed here. If you are concerned that a pharmaceutical company may have breached the Code, please inform the Prescription Medicine Code of Practice Authority (PMCPA).

ABPI Code Awareness Day is taking place on 15 May 2007 and the NAPC is supporting this initiative. On this day, more than 50 pharmaceutical companies are allocating time for sales representatives and others who have contact with external stakeholders to promote the Code to customers, doctors, pharmacists, nurses and NHS management as part of their regular programme of calls.  In addition, articles will be running in the medical, pharmaceutical and nursing press throughout May.

To find out more about Code Awareness Day, the content of the Code of Practice, its operation or to find out how to complain about a pharmaceutical company, please go to www.pmcpa.org.uk.

It has been a turbulent year. PCTs and SHAa have been through challenging times. There have been some surprising changes in personnel in the NHS. Whatever the final dramatis personae of the new organisations, there is no doubt they will be leaner and meaner. Deficits have reared their ugly head in a major way, demonstrating that throwing money into an unreformed NHS does not work.

We have also witnessed an attempt to encourage belatedly a policy which should have driven the commissioning process for the past decade - PBC. There is a feeling that PBC has run out of steam, but PBC has one final chance as the new PCTs come online - if it is exploited as the liberating, innovative system it should be, it could still be a success. If used as an instrument of control, it will fail. PBC is ailing - how can it be otherwise, without budgets and meaningful data? Solutions must be sought to ensure PBC achieves its potential for the benefit of primary care and patients.  Entrepreneurs in primary care delivery must be supported. We need the entrepreneurs to be re-invigorated, at the same as we encourage them to develop alliances with the emerging independent sector in primary care. That way lays strength and safety and a force to challenge PCTs, when necessary.

For the first time, primary care can address the issue of health inequalities across the country through access to high quality providers, both traditional practices and/ or the independent sector, whose work should start to address some of the major gaps we have seen in the delivery of primary care in inner cities. All work within the NHS, and the prospect of being able to deliver excellent services consistently across England should be welcomed.

Dr Rhidian Morris, NAPC