PBC Clusters are already reorganising!

(Published September 2006)

The latest PBC summary information produced for this newsletter by Cathy Alexander, our Director of NHS Information shows that around 10% of clusters have reorganised since May! Please be very careful about buying any practice based commissioning information from alternative suppliers. A large pharmaceutical company recently bought PBC information from another supplier but have just had to purchase our information as they found the alternatively sourced data unusable when looked at carefully due to inaccuracies and ommissions.

Collection of Practice Based Commissioning Cluster Information - As at 18th September 2006

There are currently 699 Practice Based Commissioning Clusters/Consortiums/Groups in England

This can be broken down into:

77 - The number of clusters with 2 or less practices
152 - The number of clusters with between 3 – 5 practices
208 - The number of clusters with between 6-10 practices
195 - The number of clusters with between 11-20 practices
47 - The number of clusters with between 21-30 practices
20 - The number of clusters with over 31 practices

Population comparisons

The smallest cluster covers a population of 1,288
The largest cluster covers a population of 286,155
The average size being 63,489

(The Kings Fund recommends an ideal commissioning group size of around 30,000)

Links with History

Roughly one third of clusters have a history of working together as a group of practices because:

• They were previously part of a locality commissioning group. Example - Bexley Clusters
• 
  They were previously part of a GP Fundholding group or Multifund. Example - Kingston Clusters
• 
  Part of one of the original Primary Care Groups (PCGs). Example - Wolverhampton Clusters
• 
  Working as a single PCO wide cluster. Example - Coventry Cluster

Has the situation changed at all since May 2006?

Yes – we have seen around 10% of clusters changing configuration.

Example - Leeds PCTs
There were 5 Leeds PCTs (East Leeds PCT, Leeds North East PCT, Leeds North West PCT, Leeds West PCT and South Leeds PCT). They will merge on October 1st to become 1 PCT (Leeds PCT). There was a variety of approaches to PBC from the five PCTs – East Leeds PCT was going to commission on behalf of its practices (lack of interest at practice level) whereas in West Leeds had two locality consortia, South Leeds had one agreed consortia for PBC covering some practices, and Leeds North West had a number of different PBC Clusters and some individual practices.

However, they are now going to move to PBC Clusters that follow the boundaries of the current five PCT boundaries so that they become localities within the one Leeds PCT.

Sue Knox, Business Development Director has been looking at the latest information about uptake of Medicines Use Reviews by Community Pharmacists

Last month we looked at variations across PCTs in commissioning enhanced services from Community Pharmacists as published in 'General Pharmaceutical Services in England 2005/06:Emerging Findings' This month we examine statistics from the same publication about the uptake of Medicines Use Reviews (MUR) by Community Pharmacies. MURs are an Advanced Service within the new Pharmacy Contract and may be provided by acredited pharmacists. The review involves a structured concordance centred reviews with patients receiving medicines for long term conditions. A report of the review is provided to the patient and to their GP. In England, for the year April 2006 to March 2007, payment will be made up to a maximum of 250 MURs per pharmacy at a payment of £23 per MUR.

The following PCTs were in the top 10 in total number of MURs:

• Ashton Leigh and Wigan
• Coventry Teaching
• North Birmingham
• Bristol North
• Wandsworth
• 
  
  The following PCTs were in the bottom 10 in total number of MURs:
  
• Airedale
• Ashfield
• Bournemouth Teaching
• Harlow
• St Helens

Pharmaceutical companies who wish to work proactively with community pharmacies to identify patients who would most benefit from MURs need to be aware of which PCTs are already actively involved in this service as well as those where lack of training of acredited pharmacists may be holding the service back. Both situation provide opportunities for enagement.