Practice Based Commissioning (PBC)
PBC is a United Kingdom Department of Health initiative, introduced in 2005, designed to target financial drivers, general practitioners, nurses and other primary care professionals the power to decide how NHS money is spent in their local area.
PBC is about engaging practices and other primary care professionals with the NHS (National Health Service) commissioning of services.
Through PBC, front line clinicians are being provided with the resources and support to become more involved in commissioning decisions.
PBC aims to provide high quality services for patients in local and convenient settings. GPs, nurses and other primary care professionals are in the prime position to translate patient needs into redesigned services that best deliver what local people want.
GP practices will be supported by the PCTs (Primary Care Trusts) so that they may buy in (commission) services for their patients based upon cost and quality of care. This process is expected to generate financial savings of which 7/10ths may be retained by the practice for further investment while the remainder is passed back to the PCT.
In 2006 on sites in England a study was instituted focusing on the implementation and impact of practice-based commissioning (PBC) and assessed progress against the policy’s three main objectives – better clinical engagement, better locally-provided services for patients and better use of resources – and identified barriers that were limiting its success.
Evaluation of practice-based commissioning indicated that it has had little impact in terms of improving use of resources or providing better services, and examples of initiatives attributed to PBC tend to be small-scale local pilots. GPs have found it hard to find time to engage with PBC, and one survey of GPs found that 80 per cent felt they lacked some or all of the necessary skills to be an effective commissioner.
Slow progress has been attributed to a lack of clear financial incentives and cumbersome bureaucracy in PCTs’ approval of business cases.
PBC never took off in the UK and was replaced by Clinical Commissioning Groups who now fulfil the role. This was a part of the Health and Social Care Act 2012