Learning from practice

Other PCTs, although not ‘pure’ commissioning bodies, had also taken steps towards formally separating commissioning and provider functions some time before the publication of CPLNHS.



Hounslow PCT, for example, established an ‘arms-length’ provider unit (using the SPMS contract as a model) in 2004, with responsibility for providing a range of primary care services to the PCT (including the management of the7 PCT-run practices), and some community health services (including night nursing).



While SPMS staff were still employed by the PCT, the body was developing its own business and service development strategy, which included plans for full independence from the PCT, and expansion of income generating activity (e.g. providing management and clinical services to other PCTs).



 A ‘shadow’ service level agreement was being developed to set out the services and standards the PCT required the SPMS to deliver, with the expectation that this would be performance managed by the commissioning directorate along with all other contracts and SLAs. The SPMS encountered difficulties in attempting to develop as an autonomous provider, while remaining formally subject to the constraints and regulations of the PCT, but the publication of CPLNHS provided support for the direction of travel towards separation of commissioning and provision.



The original business plan, which was originally due to be reviewed in 2006/07, is now being re-evaluated in the context of the wider discussion of the future for primary care provision.



Contact: Kirstie McLachlan, SPMS Project Director,

kirstie.mclachlan@hounslowpct.nhs.uk


Source: desk research for NHS Institute by Matrix research and consultancy