The future of practice-based commissioning (PBC) depends on policymakers at the Department of Health (DH), claimed Dr Johnny Marshall, Chairman of the National Association of Primary Care (NAPC), following a survey of PBC progress that revealed a series of barriers are seen to be inhibiting the policy.
Those barriers included GPs' workload and morale, PCT reluctance to support PBC, poor quality data, slow approval of business cases and secondary care providers dictating service redesign.
The NAPC survey of its members was conducted between November 2008 and January 2009. NAPC members include professionals working in general practices, PCTs and the private sector.
On a more positive note, the survey also suggested that self-determined membership and structure of PBC consortia proved the most successful models, particularly where supported by PCTs and employed PBC CEO/team or consultancy services.
PCT engagement was seen as essential to the success of PBC. Survey respondents suggested real performance management of PCTs where PBC is failing to thrive, as well as ensuring that budgets and timely financial and clinical data are made available to practices.
Dr Johnny Marshall said: "The future of PBC is now in the balance, resting with policymakers at the Department of Health.
"With the correct levers to refresh the scheme, coupled with engagement on the part of general practice, there is no reason why we should not see a modernisation and transformation of health services both in primary and secondary care to meet today's patients' needs."
NAPC's President, Dr James Kingsland, said: "The barriers and solutions to the successful implementation of PBC have remained largely unchanged in recent years.
"Whilst there has been progress towards the adoption of PBC at practice level, with pockets of good practice identified around the country, there still remains a significant tranche of general practice which is either disengaged or disenfranchised."