We were invited to join other practices in our area in a practice-based commissioning (PBC) consortium, but decided to plough our own furrow.
We are a large, innovative practice (12,000-plus patients) and believed the other practices would slow us down. Despite some early PBC successes generating significant savings, the PCT has not accepted our recent proposals for new PBC initiatives.
The consortium has now overtaken us and the PCT has offered the consortium - but not us - a real budget for prescribing and for referrals in certain specialties. Should we swallow our pride and ask to join?
How should we approach the consortium? The consortium practices are all smaller than ours and our initial refusal did upset them.
You should ask to join the consortium. I am sure that the future for PBC lies with commissioning for populations of 100,000 or more.
A 1998 King's Fund report on total purchasing pilot projects showed that managing the risk effectively with a budget covering non-elective care and elective care needs a population of this size.
Get in touch with the consortium and be honest as to your practice's earlier reservation about joining it. Explain that you can see the member practices have proved their worth and dispelled fears about slowing down your practice.
Say that your practice is keen to join and move faster and further with them.
I suggest briefing your PCT as it is likely to be enthusiastic and could help broker the deal.