The House of Commons Health Select Committee report on Lord Darzi’s NHS Next Stage Review, published today, has elicited mixed responses. The Select Committee report, covered elsewhere on UK News today, has been critical of the management capacity of NHS primary care trusts (PCTs) to achieve the DH’s goal of ‘world-class commissioning’.

The report’s author, Health Minister Lord Darzi acknowledged the validity of concerns, telling the FT "I accept that there is more work to be done to strengthen PCT commissioning. That is why were are introducing a new accountability process that means from this year PCTs will face a rigorous assessment against their commissioning skills.

"We are also taking steps to nurture the next generation of NHS leaders by introducing leadership and management training throughout the career paths of all healthcare professionals. Improving the quality of services will undoubtedly lead to efficiencies, not only in financial savings but also in a more efficient patient journey through the NHS."

Medical concerns over links to GP commissioning
Others have expressed their agreemnent with the report’s concern about the Darzi Review’s clack of clarity over the dividing lines between PCT commissioning and GP practice-based commissioning (PBC)>

Dr Hamish Meldrum, Chairman of Council at the BMA, said, _ Many doctors are frustratingly aware of the poor level of support available in many PCTs particularly in commissioning new services. The BMA has always supported the concept of Practice Based Commissioning as it can offer great benefits to patients, but this potential is too often squandered by the absence of adequate support or creative input from PCTs. Clearly the variable management quality in PCTs, highlighted in the report, must be addressed if patients are to benefit.”

Meldrum also echoed the report’s criticisms of central imposition of new ‘polyclinics’, super-GP surgeries with minor diagnostic capacity, open 8-8 every day. The DH has decreed that every PCT shall have one. _“ The report supports the BMA’s view that the government directive - that a GP-led health centre be introduced in every Primary Care Trust regardless of local need - was short-sighted. It also reiterates our concerns that GP-led health centres have been introduced without proper pilots or evaluation.”__

Welcome from management
Criticism was not, however, universal. Steve Barnett, acting chief executive of the NHS Confederation, (which represents over 95% of NHS organisations) said, “we feel the committee has missed an opportunity to provide a more rounded view on the NHS’ preparedness to deliver a patient-centred service.

“The concerns raised by the committee on the ability of Primary Care Trusts (PCTs) to implement the Next Stage Review are misplaced. PCTs have strengthened their commissioning capacity significantly over the last two years and have plans in place to continue this improvement. With hard won financial stability, new expertise and the world class commissioning programme, we are confident that PCTs can deliver Lord Darzi’s vision for the future of the NHS.

“This report presents a very narrow view by focusing on commissioning. The opportunity provided by the Next Stage Review is for the NHS to put quality at the heart of patient care and enable performance improvement through information to patients and empowered local leadership in the NHS.”