Sorry to avoid answering your questions directly but you might be interested
in our locality's plans to make smaller PCGs viable.
We have 4 neighbouring PCGs all between 50,000 and 78,000 patients. We plan
to risk share as far as emergency Rx and expensive regional specialities are
concerned. We also intend to achieve economies of scale by forming a joint
administrative structure, which will collect data and commission care on
behalf of its client PCGs. Executive authority will remain with the smaller
PCG, which will simply pass its commissioning requirements to the
administrative structure.
Other functions may be kept at PCG level where appropriate or delegated to
an umbrella committee (the old JCG) which will not have the final say, but
may work on joint projects where we are more effective speaking with one
voice (e.g. to block the merger of two acute trusts).
So can run small PCGs effectively if you are prepared to achieve
administrative economies of scale through co-operation with neighbours (who
may well be in the same boat).
Hope this helps. All in my head at the moment. Might turn into a discussion
document. Of course in your HA approves such a scheme then PCGs could be
even smaller (in keeping with optimum size suggested by Kings Fund).
Mark Pasola
> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of Tim Paine
> Sent: Wednesday, June 10, 1998 3:57 PM
> To: [log in to unmask]
> Subject: PCG Configuration
>
>
> We are currently assembling arguments to support our request to remain
> 'intact' as a homogeneous community of 50-70,000, rather than be
> 'swallowed up' by neighbouring - but very different - communities to
> form what our HA believes would be a more cost-effective PCG of
> 160,000+.
> Can anyone provide answers to the following?
> 1. In what ways were the smaller multifunds shown to be more
> efficient/effective?
> 2. What *evidence* is there to support the notion of an 'unsafe' size of
> PCG risk management-wise? Are there any relevant (horror) stories &/or
> solutions from multifunds etc? Could a HA not have a contingency fund
> with risk-capping for each PCG - as for standard FHPs?
> 3. What staffing is likely to be required to service PCGs of say
> 50,70,90,110K?
> 4. Is it really necessary for a PCG to have a *doctor* as its IT expert?
> Wouldn't a non-medic au fait with the h/care scene be as good?
>
> Any useful answers very gratefully received - Tim Paine.
>
>
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