Shaping PCT Provider Services
On 31 March, TPP Law sponsored and exhibited at the national Kings Fund event ‘Shaping
PCT Provider Services - the future of primary and community care’ in London.
The NHS Next Stage Review has encouraged the separation of PCT commissioning and
provider functions. The review also encourages PCTs to support greater choice and
contestability of provision within primary and community health services and greater
service integration. A range of organisational models are now possible for community
health services.
In response to these developments this conference set out to explore the strategic
challenges facing community health services and to share the latest thinking on
system reform and PCT provider services.
Dr Anna Dixon (Director of Policy at The King’s Fund) introduced the conference
by saying that despite a number of false starts there was now a clear policy direction
for PCTs to achieve separation by the end of the year. She emphasised that separation
involved more than a functional separation and there are many wider issues to be
considered.
Bob Ricketts (Director of System Development Department of Health) gave the keynote
presentation. He set out the case for change and emphasised that it is important
to ensure that the focus remains on delivering transformation in community services.
The key messages from his presentation were that:
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there is no national blueprint on how to effect separation |
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engagement of staff, trade unions, partners and external stakeholders is essential |
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commissioning strategies are fundamental |
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the benefits for patients should be paramount |
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value for money for the taxpayer should be evident |
Candace Imison (Deputy Director of Policy, The King’s Fund) went on to outline the
strategic context, setting out the challenges and opportunities for provider services
in terms of services, infrastructure, workforce, and organisation. She emphasised
the wide range of organisational options available to PCTs to achieve separation.
These include:
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PCT arm’s length provider organisation |
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Community Foundation Trust |
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Social Enterprises |
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Integration with other NHS organisations |
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PCTs contracting with integrated care organisations |
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PCTs contracting with non-NHS bodies |
The session on Key Factors Shaping Change included discussion on three areas. Firstly
workforce issues, it was suggested by the speaker, Rosemary Cook CBE, (Director,
The Queen’s Nursing Institute) that workforce is the single most important factor
that will shape change but that there was much to do to win the support of the current workforce for reform. Secondly, governance, corporate behaviour and cultural change
– Jackie Brown (Managing Director, NHS South West Essex Community Services) gave
a practical overview of what it is like to be a PCT manager at this transitional
time, her organisation has been arm’s length since April 2008. She concluded that
good governance is an enabler and that it allows focus on service delivery and improvement
within a clear framework. Finally estates and building, this presentation by Ernst
and Young outlined the changing environment and what this means for PCT boards,
the speaker also introduced strategic estates partnerships and innovative property
funding and procurement.
The session entitled Making it Happen – Risks and Opportunities comprised of three
case studies. The provider perspective was provided by Hampshire Community Healthcare.
The PCT board agreed to establish separate commissioning and provision functions
within the PCT with the aim of systematically transforming clinical services. A
population-based approach had been adopted with a focus on leadership and governance.
The commissioner perspective was represented by Birmingham East and North who were
taking a considered approach in order to improve commissioning as well as provision.
The point was raised that in a different economic context some
providers may need
to reconsider and whether increased management costs in provider arms are sustainable.
Delivering world
class commissioning/provision is clearly a pre-requisite but a
range of provision models would need to be tested first. There was also a presentation
on the lessons learned in modernising community health services from mental health
services.
A number of smaller discussion groups were held in the afternoon to consider a range
of issues including; service integration and working with practice-based commissioning,
choice and contestability, managing change and creating social enterprises.
To conclude the day a panel of speakers was asked for their opinion on the most
significant challenges and opportunities for the future. The challenges included;
time constraints, ensuring the needs of the patient remain paramount and market principles. The opportunities included the fact that the policy light is shining
on these services and despite recession providing quality services now could help
the NHS financially in years to come, provider arms could have a far greater degree
of freedom (particularly if adopting the social enterprise model) and the impact
that could be made on healthcare as a result of change.
If you would like any more information about the event or if you would like to discuss
any of the options for new governance structures, partnerships and provider models
available to PCTs please contact
Mark Johnson
or
Owen Willcox.
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For More Information Contact:
Mark Johnson or Owen Willcox
TPP Law Limited
53 Great Suffolk Street
London SE1 ODB
t 020 7620 0888
f 020 7620 0778
e info@tpplaw.co.uk
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