The London PCT policy forum, hosted by the London NHS Confederation, was established in 2003 to provide an arena for PCT chief executives to debate the key issues affecting primary care in the capital.

The forum is chaired by Robert Creighton, chief executive, Ealing PCT. Establishment of the forum followed consultation with London PCT members.

Half-day meetings are held regularly in central London to allow as many forum members as possible to attend.

Themed seminars provide an opportunity for senior PCT personnel to hear from leading-edge practitioners and to participate in workshops exploring key questions for PCTs. These meetings are open to all PCT chief executives and their nominees.

London PCT policy forum seminar: co-operation and competition in the new NHS
Tuesday 22nd July 2008

Background

Dr Sarah Crowther, Chief Executive, Harrow Primary Care Trust, chaired the meeting. Sarah is the London sponsor CEO. Her role is to act as a champion for the commercial strategy, to ensure it is developed with the support and encouragement of PCT CEOs and to communicate the strategy and its implementation to PCTs. She also chairs the Commercial Board. The Board leads on existing schemes transferring to the SHA from the Commercial Directorate and provides advisory support to PCTs on procurement, market management and dealing with the commercial sector.

NHS London is developing a network to support people working in this area. For more information, please contact Conal Timoney, Head of Commercial Development, NHS London by email on Conal.Timoney@london.nhs.uk Conal leads on market/commercial issues and is a member of the Commercial Board. He would welcome your views on how the proposed network could best support your work.

• London PCTs met to discuss co-operation and competition in the new NHS. The meeting looked at how this applies to world class commissioning, wider system management and the skills which need to be developed in PCTs.
• There were three different perspectives from the presentations. Firstly, a plea from the independent sector to be bold and to think about what you want and go for it. Secondly, an example from Camden PCT which showed that PCTs will need to find their hard hats. And lastly, a view from the Department of Health that PCTs are in the driving seat and will need to read the documents and ask the right questions. Overall, PCTs will be taking risks which will involve managing the risk and making good judgements.

Summary of discussion:

• A question was asked whether the independent sector would take on the current NHS workforce as well. The view was yes, and that the learning from ISTCs will help to do this better around issues like training and peer group audit.
• There was concern expressed about behaviour and how existing NHS providers will work with the independent sector. The experience from Camden was that practice based commissioning collaboration worked with the 3 United Health practices because they were well known local GPs. The Care UK experience was that it was initially tricky and it can take months, even years, to get acceptance.
• There was a discussion about why commissioning is perceived to have failed in the past and whether a new political party in power would change current policy.
• The DH is looking at local pricing frameworks to support the choice menu. The view was that PCTs need to decide the range of services they want and to tender for the best value provider.
• The rules based national health service is anticipated to generate noise in the autumn. The chair of the competition panel will be announced at this time.
• On penalties and incentives, there was a request for PCTs to be left to negotiate for what it wants. The new commissioning for higher quality and innovation (CQUIN) scheme will have standard national measures. CQUIN can weight issues like patient satisfaction but this needs to be a fair methodology. May want to give a heavy weighting to London maternity services.
• A key issue was FT levers in the new contract. The new contract will include penalties. PCTs will need to know all the contracts inside out. Where PCTs plan to give notice, they will need to take legal advice and make sure that it is right.
• The DH is working on another vision for PbC over the summer led by Gary Belfield. The recommendation was to send views to NHS London (caroline.mitchell@london.nhs.uk) The current guidance is in the PCT procurement guide.

Copies of the presentations given at the meeting are available to download from the panel on the right.

For more information on the work of the forum, or if you have suggestions for future meeting topics, contact the London Relations Manager, Rachel Maybank on 020 7074 3305.