Practice Based Commissioning

1
Practice Based Commissioning

• Durham Dales PCT
• County Durham

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A practical example

• Our approach in the Dales
• Practice Response
• Budget Setting

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Approach

• All practices should go at once
• Budget should include all services
• Savings based on underspend against total budget
• Practices encouraged to work together

4
PCT Action so far

• 3 seminars to GPs and PMs
• Presentations to PEC and Board
• All practices visited by PEC Chair, Chief
  Executive and Finance Director at least once.
• All practices have partial indicative budgets
• All budgets shared openly between practices,
  Board and PEC

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Practices Involved

• 12 practices in total
• All have agreed to take on indicative budget this
  year
• 3 have submitted commissioning intentions

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PCT Resources

• Practices encouraged to take up share of PCT
  staff eg commissioning/finance
• Beginning to look at monthly budget reports
• SLAs being developed for community nursing
• Agreements being reached with pharmacy team.

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Practice Intentions

• Changes to community services
• In house consultant clinics
• Increased use of AHP services
• Practices starting to look to each other to
  develop special interests
• Desire for choice and use of private sector
• Trust contracts based on quality

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Quality Issues

• Discharge letters
• Cancelled clinics
• Unnecessary bureaucracy
• Quality standards for community staff
• Improved access by all practitioners to
  investigations

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Use of savings

• Refurbishment of premises
• Practice equipment

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Acute Trust

• Still trying to rely on LDP for income
• Rogue GPs will be brought in to line?
• Only beginning to understand the new market.
• What will their reaction be to consultant clinics
  in primary care and need for theatre and in
  patent beds.