Title: Primary Care Trusts: modernising the NHS?
1Primary Care Trustsmodernising the NHS?
- Diane Jones
- Research Fellow
2Overview
- PCGs and PCTs in the new NHS
- National Tracker Survey of PCGs PCTs
- Research findings
- Conclusions
3Primary Care Groups and Trusts in the New NHS
- One of the most radical reforms since 1948
- Modernisation agenda reliant on PCTs
- IfH reliant on PCTs
4Health Service Reforms
- Core Functions of PCG/Ts
- Improve health of the local population
- Commission hospital community based health
services - Develop primary community health services
5Funding
Strategic Health Authorities approx. 1.5 million
population
Primary Care Trusts approx. 200,000
population Primary Care Community
Services Health
Services
Hospitals
6Information Flows
Strategic Health Authorities approx. 1.5 million
population
Primary Care Trusts approx. 200,000
population Primary Care Community
Services Health
Services
Hospitals
7The National Tracker Survey of PCGs and PCTs in
England
- Longitudinal survey - 72 PCGs
- Oct-Dec 1999, Oct-Dec 2000 Jan-Mar 2002
- Describe/evaluate achievements and obstacles
- Interviews - CEO, Chair, HA Lead
- Postal questionnaires
8Modernising Primary Care
- Improving access
- Extending the range of services
- Increasing the workforce capacity
- Integrating primary and community services
- Improving quality
- Information and IT systems
9Initiatives to improve access
10Extending the range of services through sharing
11Enhancing workforce capacity
12The Vision
Mental Health Services Electronic Patient Record
Hospital based Electronic Patient Record
Primary Care Electronic Patient Record
Community Services Electronic Patient Record
Social Care Records
13Modernising Information Systems
- Are information systems meeting the needs of
PCG/Ts? - Will the targets set out in Information for
Health and NHS Plan be met? - Development of IMT in general practice
14GP systems - current position
- High level of computerisation
- Accredited GP systems
- Erratic development
- Data quality questionable
15Research Questions
- What are the information needs of PCGs and PCTs?
- Do current information systems meet needs?
- How can information systems be improved?
16IMT in PCGs and PCTs
- Postal questionnaire - IMT Lead
- Response rates
- Year 1 53 (n38)
- Year 2 72 (n51)
- Case Studies
- Selected Findings
17 of PCG/Ts where information systems meet needs
well or very well
18PCG/T Information Systems
- Poor/ very poor data from
- Community Health systems (84)
- GP systems (63)
- Hospital based systems(63)
- Most had e-links to NHS Net Internet
- Few with e-links to practices hospitals
19 of PCG/Ts reporting more than half of practices
using selected links
20 of PCG/Ts reporting more than half of practices
using information management tools
21Education and Training
- 24 had an E T policy for IMT
- 46 aimed to by April 01
- 23 of PCG/Ts signed up to PRIMIS
- 26 had plans to sign up to PRIMIS
22 of PCG/Ts confident of meeting national targets
23Obstacles to progress on IMT targets
- Inadequate levels of IMT staff (71)
- Poor budget information
- LIS does not reflect PCG/T needs
- Funding diverted
24Obstacles to Progress - general (PCG/T Chief
Officers)
25Conclusions
- PCG/Ts are
- taking action to improve access to primary care
- extending the range of services by sharing
resources between practices - working to increase capacity through extended
professional roles
26Conclusions
- Development of primary and community services -
high priority for PCG/Ts - PCG/Ts are making an important contribution to
NHS modernisation - Inadequate management capacity and resources are
seen as major obstacles to further progress - Continuing tension between central control and
local autonomy
27Conclusions
- Information to support core functions is
inadequate - Ability to meet national targets is doubtful
- Practice systems - key source of data
- GP systems advanced but data quality inadequate
- Use of information tools in general practice very
low - Essential to improve data quality
- Substantial investment required
28The Third Tracker Survey
- Third survey underway
- Findings published in Autumn 2002
- www.npcrdc.man.ac.uk