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Open Monday-Friday Branch Surgeries INGLETON WRAY Telephone Enquires Tel: 015242 61202 Repeat Prescriptions Tel: 015242 42497 Surgery Closed Tel: 015242 61202 Out of Hours services are provided by Website updated |
COMMISSIONING Commissioning is the process by which the NHS plans, budgets for and procures health services. For the last few years the main commissioners in England have been the approximately 150 Primary Care Trusts (PCT), advised by Practice Based Commissioning (PBC) Groups. These are groups of local GP practices who work together to ensure that health services are in tune with the health needs of the local population. Our practice is currently a member of the Craven PBC Group. The government is planning to make wholesale changes to this system with their Health and Social Care Bill. This is an extremely complex piece of legislation which proposes to make fundamental changes to the way the health service is run. It has provoked considerable opposition and the final outcome of its passage through the Houses of Parliament are still in doubt (in August 2011). However it appears that one change is certain: the transfer of PCT commissioning powers to Clinical Commissioning Groups (CCG) in which GPs will have a powerful voice. The reason why GPs have an important place in commissioning health services is that finding the best care for our patients is one of our main tasks. That may be to advise on when you need to go into hospital or to be referred to a hsopital specialist; it may be to advise that you need podiatry or the services of a community mental health team. We have to find the best services that will meet the specific needs of of individual patients. This knowledge helps us to understand how local health services can be developed to meet the needs of the local population while making best use of the limited resources available to the NHS. Bentham Medical Practice Although we are based in High Bentham in North Yorkshire and over 6,000 of our patients live in Yorkshire, 95% of our referrals to hospital are to the University Hospitals of Morecambe Bay Trust (UHMBT). However none of the other Craven practices refer more than a handful of patients to UHMBT. Because of the travelling distances and public transport limitations, they work with Airedale NHS Trust which is in the process of merging with NHS Bradford and Airedale, Bradford District Care Trust and Bradford Teaching Hospitals NHS Foundation Trust. This means that the work of Craven PBC group focusses on services provided by Airedale and Bradford Trusts and we have little opportunity to use commissionning to the benefit of our patients. It also means that we are excluded from commissioning discussions about the services our patients do want to use in UHMBT. For this reason we have begun to explore the opportunity that the Health and Social Care Bill may offer for us to break our link with the Craven and join the South Cumbria Commissioning Group. Apart from giving us direct commissioning influence over UHMBT to the benefit of our patients it will offer a nember of other advantages, particularly if the current plans fo the rest of the Craven practices to join a new Airedale and Wharfedale CCG that will focus even more on the services provided by NHS Bradford and Airedale for a much more urban population. The advantages of the move will include:
The move has the support of the practice Patient Participation Group. The other options for our practice are unappealing: Follow other Craven practices into the Airedale and Wharfedale Trust if plans for their cross county boundary move are agreed. This will increase the isolation and irrelevance of Bentham practice in comissioning decision making. If the rest of Craven practices do not merge with Airedale and Wharfedale we will either remain as a very small CCG without the finacial security to commission effectively or will have to merge with a neighbouring North Yorkshire CCG, presumably Harrogate which would be of no benefit to Bentham patients. Bentham patients will remain disadvantaged and unable to realise benefits of the Health and Social Care Bill by being effectively excluded from commissioning. We could, pending the final wording of the Health and Social Care Bill and accompanying regulations, remain an independent practice, effectively becoming a commissioning group of our own or become the only Craven practice linked to a neighbouring North Yorkshire CCG. Next Steps The practice has sought and recieved the agreement and support of the NHS Cumbria and the South Cumbria Commissioning Locality, North Yorkshire and York PCT and the remaining practices of Craven PBC Group to move to the South Cumbria CCG. We are awaiting the response from the Yorkshire and Humber Strategic Health Authority to our formal request to move. Meanwhile we are building increasingly strong links with the South Cumbria teams. 30th August 2011 |
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