Clinical heads are still not getting a say in strategic decision-making at 10% of primary care trusts, despite guidance from the Department of Health that they should be fully involved, delegates to the first National PEC Chair conference were told yesterday.

The findings were from a survey undertaken by the NHS Alliance, which also found that: one in five PCTs haven’t yet fully established Professional Executive Committees, overshooting the deadline set in the DH’s latest guidelines by one month; PECs are not really involved in commissioning in 23% of PCTs; nearly two thirds of PEC chairs have described poor links with their strategic health authorities; and four in ten PCTs are not providing access to training for their PEC members.

Every PCT has a PEC and, according to the DH, they represent an important aspect of clinical leadership in primary care. The PEC has four umbrella functions: to support the PCT in developing its vision and strategic direction; commissioning and supporting practice-based commissioning; clinical effectiveness and clinical governance; and leading clinical communications with partners and stakeholders.

To this end, the DH insists that PECs have a majority of members – such as GPs, nurses, social workers, pharmacists, etc - whose work reflects the function of the PCT, thereby enabling the group to “provide a professional viewpoint” in carrying out its duties.

New guidelines
In March this year, then Health Minister Andy Burnham launched a set of guidelines for PECs to help foster relations between clinicians and managers for better decision-making. At the time, Burnham reaffirmed his belief that “successful clinical leadership is paramount” for health reform, and stressed that “clinicians need to have a much bigger role in the design and development of local services because they understand what patients want and how they can deliver it”.

“It is the duty of all managers and clinicians to take responsibility for embedding clinical leadership and empowerment in their organisations,” he added.

But, going by the results of the NHS Alliance’s survey, the DH’s vision for the role of PECs is not being followed as closely as it had hoped, at least in some areas.

“There is a massive variation across the country in how PCTs and SHAs are approaching clinical leadership,” Commented Peter Reader, NHS Alliance national lead for clinical leadership. “Some – such as the East of England and North West SHA areas – are providing excellent imaginative leadership. But we are still too often seeing managerial/clinical tribalism along with worrying indications that clinical leaders are being sidelined, under-valued and undermined. The best should show the rest how it should be done. Fast.”