The Health Committee has launched a new inquiry into potential changes to the Primary Care Trusts' functions and numbers arising from Commissioning a Patient-Led NHS.

Terms of Reference:

• Rationale behind the changes

• Likely impact on commissioning of services

• Likely impact on provision of local services

• Likely impact on other PCT functions, including public health

• Consultation about proposed changes

• Likely costs and cost savings

Two evidence sessions will be held, on Thursday 3 November and on Thursday 10 November 2005. A later press notice will give details of these.

Responding to the debate, the BGS submitted the following comments

Rationale behind the changes
We welcome the enlargement of PCT borders which makes it potentially easier to coordinate the planning of services between a Hospital Trust and one large area which that Trust serves. This will often create co-terminosity with Local Authority boundaries which again could assist integrated working.

Likely impact on commissioning of services
The separation of commissioning and providing may remove the perverse incentives, which have developed with Payment By Results. One large commissioner, with a number of provider organisations, should reduce this and facilitate commissioning an integrated service.

Likely impact on provision of local services
Most secondary care services do need to be commissioned at a “higher level” but the recent development of effective locality planning may be lost in the process. There is uncertainty around whether this will be replaced by practice-based or by high level commissioning.

Likely impact on other PCT functions, including public health
Public health services were weakened and fragmented by the current PCT structure, and so should be strengthened again by coming together at county level.

Consultation about proposed changes
Within elderly care there is uncertainty around who will be providers of Community Hospitals and Intermediate Care. More widespread discussion might have developed solutions to such problems that are now causing apprehension.

Likely costs and cost savings
No comments.