PCTs are the health organisations in the NHS that deliver primary health care services (doctors, dentists, opticians, nurses, health visitors etc) and they also commission services from other health care providers such as hospitals and specialist centres.
Whilst many local people are not that aware of what a PCT is and the role it plays, they are important behind the scenes players in the first points of contact people have with medical professionals in the community.
The question is, how can PCTs do this?
Traditionally PCTs have focused on delivering blocks of service and mass purchasing. They are part of the historical legacy of the NHS - coming with all the strengths and idiosyncrasies that this unique and wonderful organisation has. And PCTs do a pretty good job for much of the time.
PCT 2.0 will have to be very outcomes focused. Outcomes that include better accountability, transparency, participation and effectiveness. Of course this is probably also going to involve a major rethink of the power relationships between the users and providers of health care. This might be scary for organisations but who said change was easy. It might also mean that new skills are required.
Like the new internet, technology has a part to play in this shift. As data and information systems get better and less linear there will be opportunities to connect with different people in many different ways. It will also be possible to appreciate the resources that exist within the health sector and deploy these in different ways.
An added advantage of this direction could be that the greater empowerment of local people might reinforce the need for people to better self-manage their health and take control of their lifestyles. It is already becoming clear that whatever resources we allocate to health will not be enough for the increase in need and demand. But by supporting people to reclaim their health (recognising their own self-knowledge and expertise) it may be possible to use scarce resources more effectively.
It is fun to speculate and look to the future. In writing this article I am also painfully aware of how much jargon I have used - it just seems to flow out of my finger-tips as I type. One thing I like about Web 2.0 is that the conversation never ends - I am just waiting for other posters to challenge the jargon. Go for it. But also, in terms of PCT 2.0 the conversation should never end with our local communities. Engagement ceases to be a task and becomes a continuing process leading to growth and change.
Perhaps in future PCT annual reports we should ask that they demonstrate the relationships they have built and the conversations they have sustained - if we could get a metric that gives a value to this on the balance sheet we might even begin to capture the value that this brings to local people!
My view is that PCTs should be crucial conduits to local peoples’ engagement with all their local health services. They should work together to understand what local people need and want from their health system and then go out to make this a reality. PCTs should therefore have direct and deep relationships with their communities.
They should be able to involve local people in all parts of the commissioning of services - including deciding on local need, procuring or purchasing services, monitoring how those services are being delivered and provided, and evaluating the outcomes of services which of course then feeds back into a new appreciation of local need.
PCTs should be organisations that do things with local people - not to them. Let us not forget that PCTs have big budgets of local peoples’ money and have to be accountable for this.
The question is, how can PCTs do this?
Traditionally PCTs have focused on delivering blocks of service and mass purchasing. They are part of the historical legacy of the NHS - coming with all the strengths and idiosyncrasies that this unique and wonderful organisation has. And PCTs do a pretty good job for much of the time.
I think there are at least six areas where PCT 2.0 could make a major shift in focus:
1. Building new and complex connections between patients, local people, health service planners and professionals - both in terms of vertical and horizontal relationships and in terms of more multi-layered non-hierarchical relationships.
2. Finding new ways for people to come together to discuss health and be creative. PCTs unique position might give them the opportunity to facilitate and broker these new connections adding great new value to the local health economy. In doing so the PCT also becomes more valuable and useful to local people. One clear message from research into Web 2.0 is that people value the expertise of their peers and enjoying asking questions of people like themselves as well as to more traditional experts.
3. Increasing the availability and openness of information to the community about health services and choices - and making this information available in a variety of user friendly formats and in real time.
4. Capturing and sharing the experiences, views and local expertise of the community as both consumers of health services and as active partners in the commissioning of better services. This pool of knowledge and expertise could then be used for greater improvement and individuality of services
5. Offering new opportunities for voice, participation and involvement - especially from diverse groups such as young people, BME communities, disabled people and those who are terminally ill. Crossing the traditional boundaries of health and social care services and their respective silos to follow the real life journeys of people (whose lives are more rich and complex than our organisational structures can hope to recognise)
6. Looking at health services as a series of experiences that should please, satisfy and delight the user rather than as purely transactional relationships.
PCT 2.0 will have to be very outcomes focused. Outcomes that include better accountability, transparency, participation and effectiveness. Of course this is probably also going to involve a major rethink of the power relationships between the users and providers of health care. This might be scary for organisations but who said change was easy. It might also mean that new skills are required.
Like the new internet, technology has a part to play in this shift. As data and information systems get better and less linear there will be opportunities to connect with different people in many different ways. It will also be possible to appreciate the resources that exist within the health sector and deploy these in different ways.
An added advantage of this direction could be that the greater empowerment of local people might reinforce the need for people to better self-manage their health and take control of their lifestyles. It is already becoming clear that whatever resources we allocate to health will not be enough for the increase in need and demand. But by supporting people to reclaim their health (recognising their own self-knowledge and expertise) it may be possible to use scarce resources more effectively.
It is fun to speculate and look to the future. In writing this article I am also painfully aware of how much jargon I have used - it just seems to flow out of my finger-tips as I type. One thing I like about Web 2.0 is that the conversation never ends - I am just waiting for other posters to challenge the jargon. Go for it. But also, in terms of PCT 2.0 the conversation should never end with our local communities. Engagement ceases to be a task and becomes a continuing process leading to growth and change.
Perhaps in future PCT annual reports we should ask that they demonstrate the relationships they have built and the conversations they have sustained - if we could get a metric that gives a value to this on the balance sheet we might even begin to capture the value that this brings to local people!
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