Turning round NHS deficits: ...is more difficult for PCTs

doi:10.1136/bmj.332.7537.363

BMJ 2006;332:363 (11 February), doi:10.1136/bmj.332.7537.363

Letter

Turning round NHS deficits

...is more difficult for PCTs

The first 150 words of the full text of this article appear below.

EDITOR—Ham believes that the turnaround teams from theprivate sector will find it difficult to deal with NHS deficits.¹The solution he describes entails reducing spare capacity, increasingperformance, and fully engaging clinicians. These measures,aspects of the failure regime for hospitals,² have some chanceof success in provider organisations. The position for primarycare trusts (PCTs) in deficit is even more difficult and likelyto be even more alien to the expertise of those now being boughtin from the private sector as recovery teams.

Primary care trusts are largely commissioning organisationsand do not have direct levers to reduce acute capacity, evenwhen it is recognised not to be affordable. Directly providedservices form only a small proportion of their spend and areneeded to help reduce hospital activity. Were local hospitalsto increase their efficiency—say, by reducing length ofstay—this would exacerbate the problem for . . . [Full text of this article]

Hilary G Pickles, director of public health

Hillingdon Primary Care Trust, Yiewsley UB7 7HJ hilary.pickles@hillingdon.nhs.uk