Herding cats

On April 1, 2013, primary care trusts’ commissioning functions were moved to the long awaited new NHS Commissioning Board. Within the first week, the Board adopted the name ‘NHS England’ (although legislative changes since continue to refer to ‘the Board’).

The brave new world was awaited with anticipation and some trepidation. For the first time in years, centralisation promised consistency. However, would it be consistently bad? Despite months of preparation and shadowing of the PCTs, NHS England (NHSE) failed to publish its’ policies in relation to primary care dentistry on time.

However, during May and June, it became clear that new policies, though unpublished, were being enforced by some local area teams (LATs). Finally in June, NHSE published its policies in relation to mid-year and end of year performance, incorporation, PDS to GDS conversion, contract termination, the death of a ‘single-handed’ contractor, and variations to contracts.

Some policies hold the promise of positive consistency. For example, the policy on incorporation sets out, for the first time for all contractors in England, the criteria which must be met and the application form which must be used in order to obtain consent. This is a far cry from the range of policies (or absence of policies) that existed previously across PCTs.