An early action by the then new Labour government in the late 1990s was to remove the "wasteful" purchaser provider split in the NHS - the creation of Primary Care Trusts being one element. These new organisations both provided local community services but also purchased the hospital care for the people of the area. This replaced GP "fundholding" where GPs or groups of GPs were allocated a budget to buy the care for their patients, although not all GPs took up fundholding.
By April 2009 it seems that splitting delivery of local services from bodies which also control the budget is back in favour. From 1st April all PCTs have been required to separate their functions - with all community services being run by an autonomous section of the PCT. From next year they will have to be completely separate legal providers. This will mean that services will be delivered within the context of formal contracts which will have to drafted, agreed and most importantly managed, rather than direct line management.
Bromley PCT provider unit is considering two options as to its status next year. It's least favoured is for the community services to be taken over by Oxleas NHS Foundation Trust with it's preferred option being the creation of an independent social enterprise.
A new Community Interest Company would be formed which would operate on a commercial basis but re-invest any surplus into local health services. It would be legally separate from the NHS but the leaflet issued by the new autonomous provider unit stresses that services will appear to be NHS services and have NHS branding .As the leaflet says -"This has the advantage of the organisation maintaining trust and reputation of NHS services can carry and not being confused with private healthcare". This seems a crucial advantage since what are now NHS service Will be run by a private company - albeit one run on not for profit lines. After all one of BUPA's selling points in competing with other private providers is that it doesn't have shareholders and re-invests its surpluses into services.
The PCT Board will make a decision on the two options at its June 25th meeting. It is not clear yet whether there will be any opportunity for patients and community groups to actually influence the eventual outcome. I am doing my best to find out more on this point. The formal split is a fait acompli - being national government policy - but how it is put into practice will be of concern to many. Perhaps you have opinions on the options - or different ideas altogether?
I have tried to email the adress given in the material I recieved from the PCT but it "bounced back". More news as I get it.
Posted by: S Blann | 05/05/2009 at 10:32 AM
this has been overtaken by events, includign change of government and a new Health and social care bill. see the CLB website - http://www.communitylinksbromley.org.uk/pr/Equity_and_excellence.doc
Posted by: stephen blann | 18/07/2011 at 01:51 PM
Indeedd the "listening exercise" after the unpopularity of the proposals
Posted by: stephen | 18/07/2011 at 02:20 PM
Thank you for this. Would it be possible to put links to the Futures Forum report for example?
Posted by: Jean Levy | 20/07/2011 at 10:34 AM
yes we would welcome anyone posting inforation they are aware of - like the furure forum http://healthandcare.dh.gov.uk/future-forum-report/ - that will get people discussing more. of course we will continue to update the polciy review pages on the CLB website http://www.communitylinksbromley.org.uk/pr/policy.html there will be updates on the developetms in NHS reform soon.
Posted by: stephen blann | 20/07/2011 at 11:22 AM