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Can Do!  Commissioning

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Commissioning

How PCTs are engaging clinicians in top-level decision-making.

If PCTs are to plan local health services effectively - and improve on them - they must tap into the expertise and experience of the whole spectrum of frontline clinicians, whose contribution is essential to forming a comprehensive view of health and care needs.

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Commissioning must be shaped by active communication with, and the free flow of information from GPs, practice nurses, dentists, pharmacists, optometrists and other allied health professionals. They should be involved across the spectrum of commissioning, from assessing need to monitoring performance (though not all clinicians need to be actively engaged all the time). Clinicians with relevant experience should be encouraged to become commissioning leads where appropriate.

Yet a danger exists that primary care professionals may feel much less involved in their PCT than other NHS staff groups do in their organisations. After all, practices had no say in which PCT they were allocated to. PCTs are comparatively new organisations, and several may have been created by dividing one health authority or a single PCT formed by amalgamating several primary care groups. Most clinicians are physically located not in the PCT itself but in general practices or community clinics. The advent of the PCT will probably have brought no immediate change in their terms of service or their day-to-day business. A PCT may therefore risk appearing remote or irrelevant, or having its role misunderstood, if it fails to engage its clinicians and offer them a route to influencing how it is run, how services are redesigned and patients' care pathways defined.

However, examples abound of PCTs that are beginning to do this successfully. The prize is a strategy that has credibility 'on the ground' and which ensures that decisions are appropriate to both patients' and practices' needs.

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