Notes from the field of public involvement

Thursday, 24 February 2005

Latest PBC guidance = stronger patient involvement

Technical Guidance for Practice Based Commissioning (PBC) was issued on 23rd February. It contains the following statement about patient involvement which makes an even stronger case than the December guidance did for the ongoing involvement of patients and the public in taking decisions about what services a practice should commission and how to spend the practice’s commissioning budget.

This will undoubtedly drive patient participation in all its forms in primary care practices who are considering taking up PBC. The challenge is to make that involvement meaningful and to show the evidence that it was effective in the commissioning process.

For established patient participation groups, this guidance should be the basis for discussions as soon as possible with their practices about intentions towards PBC. If a practice is approved by the PEC of the local PCT to hold a commissioning budget, then it will be necessary to have an appropriate shared decision making process in place. There is no one model about how to do this.

The guidance also makes clear, for the first time, that a practice which does not follow this approach to involving patients and the community in PBC will be in breach of its Section 11 duties and that the remedy for this failure will lie with the respective PCT. That will be a considerable challenge to most PCTs.

Here is the excerpt about patient and community involvement. The full technical guidance can be found at http://www.dh.gov.uk/assetRoot/04/10/41/53/04104153.pdf

Practice Based Commissioning Technical Guidance
Paragraph 13:

"In order to protect the integrity of the local health system and to check developing thinking against the views of patients and local communities:

We expect that patients and local communities are involved in the planning of Practice Based Commissioning and in the decision making process for the use of the budget. It should be noted that PCTs retain responsibility for ensuring that section 11 of the Health and Social Care Act 2001, the duty to involve and consult patients, is carried out in the Practice Based Commissioning context."

The Department of Health press release says:

"Technical guidance on Practice Based Commissioning, published today by Health Minister John Hutton, encourages practices to hold budgets for the full range of patient care, not just elective care. This will give the best opportunity for clinicians to redesign services to better meet the needs of the patients.

Mr Hutton also confirmed that GPs will be able to invest savings gained under Practice Based Commissioning in premises and other capital developments – such as new diagnostic equipment – to develop a wider range of services in a primary care setting."

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