The National Association of Primary Care (NAPC) chairman has called the Healthcare Commission's State of Healthcare report "possibly one of the most penetrative and incisive in the history of the NHS".
Yet Dr James Kingsland, Chairman of NAPC, also said it was "disappointing to note that the performance of primary care trusts (PCTs) has declined" in 2006/07.
Dr Kingsland attributed this partly to "the major reorganisation experienced at that time" and partly to the financial state of the NHS.
"Primary care is a complex sector," said Dr Kingsland, "and there are few leaders out in the field, who have a genuine understanding and appreciation of the potential of primary care. These leaders need to be cultivated, some coming from general practice, and others from outside the NHS.
"It is possible, with imagination and in partnership with local players, to deliver equally high standards of healthcare to local populations, in underdoctored areas.
"Opportunities are being wasted because PCTs do not develop constructive relationships with the best of their existing practices, which could provide solutions to local problems. Practice-based commissioning provides a vehicle to bring about major improvements in services, which is currently not being used to its potential.
"The vast majority of general practice delivers world-class primary health care services, and opportunities are being missed to harness their enthusiasm and skills to turn poorly performing local authority wards around."
Your comments: (Terms and conditions apply)
"I agree that PCTs do not support practices as well as they could, for example in managing long-term conditions. We have clinical computer systems capable of showing improved patient outcomes due to better patient education by qualified practice nurses. But two recent surveys have indicated that many nurses are expected to manage patients with long-term conditions like asthma and COPD without adequate training. It may initially seem a cheaper option to employ a less qualified nurse, but it costs the NHS a lot more in avoidable hospital referrals, out-of-hours care and admissions. PCTs could use the information they already have in order to help practice teams in need of improving their services" – Name and address supplied