White Paper Reconciliation 1

Last week was an historic one. Most people picked up that something seismic had happened, but weren’t entirely sure what, as enquiries came in from pharmacists to MPs to venture capitalists.

We had set out a prescription for success that we deemed necessary for the White Paper and in this and blogs to follow I will be picking up on the hits and misses. The first miss was that we recommended ditching the word ‘commissioning’, because it is a confusing term, encompassing a huge range of functions (buying, selling, planning, strategy, monitoring, evaluating, performance management, specialism appraisals, data collection, reconfiguration, IT systems) and GPs can’t do them all. (David Stout of the NHS confederation makes the same point). They can delegate, contract and sub-contract and that makes them more like Trusts or Authorities. Considering that their consortiums will now, to satisfy Treasury rules, have to become statutory bodies, “GP Trusts” or “Practice-based Trusts” are probably more accurate descriptions and less confusing too. However we made the correct assumption that GPs would certainly be put in the driving seat of the NHS.

And secondly we hoped that top down reorganisation of PCTs was not included in this Paper, and that their future could be determined by the gradual reshaping of the system that would be led by the GP consortia. We foresaw their attrition but thought that this sort of bottom-up evolution should be in keeping with the aim of less political, structural reform and more progressive, clinically led service development. The challenge will now be in keeping PCTs viable as some able staff jump ship as quickly as they can (to the independent sector ready and able to expand commissioning support) and all staff battle with morale as the PCT vessel gradually sinks.

About Julia Manning

Julia is a social pioneer, writer and campaigner. She studied visual science at City University and became a member of the College of Optometrists in 1991, later specialising in visual impairment and diabetes. During her career in optometry, she lectured at City University, was a visiting clinician at the Royal Free Hospital and worked with Primary Care Trusts. She ran a domiciliary practice across south London and was a Director of the UK Institute of Optometry. Julia formed 20/20Health in 2006. Becoming an expert in digital health solutions, she led on the NHS–USA Veterans’ Health Digital Health Exchange Programme and was co-founder of the Health Tech and You Awards with Axa PPP and the Design Museum. Her research interests are now in harnessing digital to improve personal health, and she is a PhD candidate in Human Computer Interaction (HCI) at UCL. She is also dedicated to creating a sustainable Whole School Wellbeing Community model for schools that builds relationships, discovers assets and develops life skills. She is a member of the Royal Society of Medicine’s Digital Health Council. Julia has shared 2020health's research widely in the media (BBC News, ITV, Channel 5 News, BBC 1′s The Big Questions & Victoria Derbyshire, BBC Radio 4 Today, PM and Woman's Hour, LBC) and has taken part in debates and contributed to BBC’s Newsnight, Panorama, You and Yours and ITV’s The Week.
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1 Response to White Paper Reconciliation 1

  1. Capodimonte says:

    Interesting article, thanks.

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