Meeting the information and budgetary requirements of primary care groups Commentary: Accurate information may be difficult to produce

Abstract

# Meeting the information and budgetary requirements of primary care groups {#article-title-2} Primary care is experiencing another wholesale reorganisation as the government's “new NHS” is implemented. The intention is to bring general practitioners and other healthcare professionals together at a local level to assess the needs of their shared populations and to ensure that resources are allocated to meet those needs. The mechanisms chosen for England (primary care groups) and Wales (local health groups) have more in common than those for Scotland (primary care trusts and local health care cooperatives). The differences among the three countries represent a worrying fragmentation of “national” health service structures. Primary care groups (PCGs) are not voluntary; all general practitioners are members of a primary care group. Shadow groups started operating at the end of October 1998and go live in April 1999. Their three main areas of responsibility include the development of primary care, the commissioning of secondary care services, and a quality agenda delivered under the umbrella of clinical governance. Only level 1and 2groups will exist from 1999; primary care trusts, described by one civil servant as “PCGs in long trousers,” with their wider remit to include community health services, will not start until 2000.Current NHS community trusts, together with primary care groups, will be able to bid to progress to primary care trusts. Level 1groups will have a largely “advisory” role in the commissioning of secondary care services. Level 2groups, in contrast, will take charge of at least 40% of their unified budget to purchase secondary care services. The government's stated aims for all levels are similar: tackling variations in quality of care and distributing NHS cash more fairly. “The healthcare needs of populations, including the impact of deprivation, will be the driving force in determining where the cash goes.”1 Few will argue with these aims, but clearly any redistribution exercise will mean winners …