PCT reconfigurationA change in the number and nature of primary care trusts (PCTs), which have been responsible for commissioning healthcare services from providers in the UK, as set out in the Department of Health’s Commissioning a Patient Led NHS initiative. The 2006 PCT reconfiguration was marked by the reduction in number of PCTs from 303 to 152 and a major shift in the role, accountability and performance expectations of the reconfigured PCTs.
• Changed role—PCTs can decide how to best provide services to meet local health needs. They have full discretion and control over budget allocation and activity commissioning.
• Larger, more complex—PCTs have challenges associated with merger—e.g., disillusioned staff, conflicting strategies, different systems, working practices, etc.
• Increased accountability—Greater board oversight from the Department of Health and their corresponding strategic health authorities; greater transparency and public scrutiny.
• Higher performance expectations—PCTs have defined financial metrics and outcome targets, with expectations that spending will be directly linked to outcomes and provide value for money.