Primary care clinicians make thousands of treatment and referral decisions each day. They can therefore have a big impact, especially in the current financial climate, on how NHS resources are used to deliver better care, better health and better value for their practice populations. Practice Based Commissioning (PBC - also referred to as clinical commissioning) recognises this role. It aims to give local clinicians greater power and influence in their partnerships with Primary Care Trusts (PCTs) so that services are better shaped to meet the needs of the community.
Under PBC, practices receive a notional budget from the PCT with which to ‘buy in’ health services. The PCT provides management and financial incentives as well as support in using data, public health and performance information. PBC practices then work with care professionals and patient groups to produce ideas and business cases for more efficient services. In order to be approved by the PCT, the business cases must show how savings can be made and care quality can be improved. Very often, the PBC ideas involve providing care closer to home for patients and their families.
Although each GP practice manages its own PBC budget, the majority in Yorkshire and the Humber work in local groupings or PBC consortia. There are currently around 60 of these across the 14 PCTs.
PBC is important to PCTs and to the SHA as a sign of partnership working with clinicians and as part of a ‘world class’ approach to improving health and wellbeing.
For further information on PBC click here.
Some examples in our region of service re-designs from successful PBC business cases are:
- Deep vein thrombosis case management
- City-wide dermatology pathway re-designed
- Community based rheumatology and ENT services
- Prostate injections and contraceptive implants provided by all practices in the District
- Pathway development for knee, shoulder and spinal orthopaedic assessments
- Prostate cancer follow-ups in primary rather than secondary care
- Out of Hours and A&E services integration