News / PCTs await financial detail of assurance

11 July 2008

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Primary care trust finance managers are still awaiting confirmation of how finance will be assessed as part of the World Class Commissioning assurance framework, despite the publication of an assurance handbook in June.


The Department of Health's new commissioning assurance system will measure PCT performance in health outcomes, competencies and governance. It will combine self-assessment, self-certification, feedback from partners, evidence gathering and review of data with a Monitor-style board review day.

'Making sound financial investments' is one of 11 competencies used to assess how PCTs have moved towards world class operations. But the finance competency is being assessed as part of the governance element of the framework, rather than within the competencies section.

Three indicators have been identified for each of the 10 non-financial competencies and the Department has provided detail of what constitutes level one to four performance in each of these indicators. The full detail of the financial assessment has yet to be published. Department director general of commissioning Mark Britnell said details were still being finalised by the Department's finance directorate.

By being assessed under the governance element, PCTs' financial competencies will be subject to a different style of reporting - receiving a red, amber green assessment instead of being assessed on a scale of one to four.

The governance assessment is made up of three components - with PCTs assessed on strategy, finance and board. Although the mechanics of the finance assessment are yet to be published, it will examine three aspects: the sustainability of the PCT's financial position; the quality of its ongoing financial management; and the accuracy of its planning and projections.

But managers said they were keen to find out how the financial examination would fit with the Audit Commission's use of resources assessment.

At June's NHS Confederation conference, Mr Britnell said the assurance framework would help support major improvement in commissioning, providing a better balance between the strength of commissioning and provision. 'It is not conceivable to think of an NHS that is fit for the next 50 years that is solely reliant on supply side strength,' he said.  But he assured PCTs that the assurance framework and the competencies element in particular was 'about development not punishment'.