Memorandum submitted by Karen Rhodes (PCT
3)
I don't doubt that there are opportunities in
the proposed reforms to save on management costs, strengthen commissioning
and to create improvements for patients but would like to ask
the Select Committee to consider the following in their deliberations:
— Is it realistic/possible to transpose
the Choice agenda in secondary health care to primary and community
services and has this been given the due consideration it needs?
How can plurality of provision and contestability be delivered
in rural areas? I believe a wider range of services is needed
outside of hospital but this does not mean duplication, especially
given the existing recruitment challenges within certain key professional
groups.
— How will accountability and performance
assessment work in a mixed economy for out of hospital care?
— Why is the Government making these
changes when PCTs' efforts to improve local services are only
just taking effect?
— One of the real benefits of PCTs'
has been the ability to provide front line clinical involvement
in all aspects of commissioning (through engagement of Independent
Primary Care Contractors and PCT employed clinical staff working
within community services). I understand the reforms are intended
to strengthen commissioning by separating it from provision however
if commissioning decisions in the future are to be made largely
by primary and community health care professionals through Practice
Based Commissioning why are PCTs' being told they must separate
provision and commissioning?
— The delivery of care to highly vulnerable
people in the community requires increased coordination and integration.
How will diversity and multiple providers achieve this?
— A briefing for senior PCT officers
prior to the publication on the statement on future of PCT provision
within Commissioning a Patient led NHS would have been helpful.
The impact this has had on highly committed NHS staff within PCTs'
has been regrettable.
Please note the comments I make are from a personal
not a PCT perspective. I hope you find them helpful.
Karen Rhodes
Director of Primary & Community Care
North Lincolnshire PCT
28 October 2005
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