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首页> 外文期刊>Journal of health services research & policy >Commissioning processes in primary care trusts: a repeated cross-sectional survey of health care commissioners in England
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Commissioning processes in primary care trusts: a repeated cross-sectional survey of health care commissioners in England

机译：初级保健信托中的调试过程：英格兰医疗委员会的反复横断面调查

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Objectives: To determine the extent to which primary care trusts (PCTs) in England employed processes associated with quality commissioning and to assess whether changes occurred in these processes during a policy drive to improve commissioning. Methods: Telephone surveys of PCT managers leading commissioning for diabetes, chronic obstructive pulmonary disease (COPD), coronary heart disease (CHD), and emergency and urgent care in all 152 PCTs in both 2009 and 2010. Results: The response rate was 51% (77/152) of PCTs in 2009 and 60% (91/152) in 2010. Two-thirds of commissioners had commissioned initiatives starting in the previous financial year. Over half of initiatives starting in 2008/09 had been instigated by the PCT alone. This reduced to a third in 2010, showing a shift towards partnership working. Commissioners reported that a large proportion of initiatives had been developed and shaped with the involvement of general practitioners (GPs) with direct links to the PCT and of specialist clinicians (70%), but that a lower proportion of initiatives had involvement from other GPs (40%). Patients or the public were less likely to be involved in initiatives than clinicians, but there was evidence of increasing involvement over the two years from 35% (52/149) to 51% (67/132) of initiatives. There was no evidence of changes in whether needs assessment was undertaken, how evidence was used or how initiatives were led and performance managed. Conclusions: PCT commissioners reported clinical engagement in the majority of commissioning initiatives, a shift towards partnership commissioning, and increased involvement of patients and public in the development of initiatives. The new model of commissioning in England through clinical commissioning groups will need to improve on these processes if it is to demonstrate a higher quality approach to commissioning.
机译：目标：确定英格兰的初级保健信托（PCTS）与质量调试有关的流程，并评估这些过程中是否发生变化，以改善调试。方法：在2009年和2010年的所有152个PCT中，糖尿病，慢性阻塞性肺病（COPD），冠心病（COPD），冠心病（CHD），冠心病（CHD），冠心病（CHD），紧急和紧急护理的电话调查。结果：响应率为51％ （77/152）PCT在2009年和60％（91/152）的2010年。三分之二的委员委员会在上一财政年度开始委托举措。从2008/09年开始的一半举措曾被PCT煽动出来的。这减少到2010年的第三名，表现出伙伴关系工作的转变。委员报告说，已经开发了大量的举措，并通过纳入一般从业者（GPS）与PCT和专业临床医生（70％）的直接联系，但较低的举措比例从其他GPS参与（ 40％）。患者或公众不太可能参与举措，而不是临床医生，但有证据表明从35％（52/149）到51％（67/132）举措的两年增加。无论是否需要评估，没有有证据情况，如何使用证据或如何实现举措和绩效管理。结论：PCT专员报告了大多数调试举措的临床参与，转向伙伴关系调试，以及增加患者参与和公众在制定举措中的发展。通过临床调试团体，英格兰调试模型将需要改进这些流程，如果要展示更高的调试方法。

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