Archway Surgery. Archway Development & Consulting Ltd
PBC Briefing Notes (Dacorum and Watford)

PBC Background

The Answer Lies in Outpatients?

CATS and CAS: Clinical Assessment and Treatment Centres

Extreme CATS

Primary Care Trust Offices
Briefing note: Dacorum
World Class Commissioning
Dacorum PCT
NHS Organisations impacting Primary Care
Archway Development &   Consulting Ltd
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   NHS Guidance pdf     Commissioning Web Site     Payment By Results Delay  Primary Care Contracting

 World Class Commissioning

Practice Based Commissioning is Dead
Long Live World Class Commissioning

The NHS has been assailed by Government initiatives since 1997.
The flow of initiatives brings on new organisations, new regulatory bodies,
new web sites, new “arms length bodies” (quangos) along with consultancy
companies feeding their associates (see list here).

These organisations, which include Strategic health Authorities, Primary Care trusts,
are then churned but never closed. We see them morphing, merging, and spawning.  For the employees it is a matter of musical chairs; but this game is different.  
New chairs are added at each round. The trick is to get into a more comfortable position each time the music stops.

All this is quite divorced from patient care. Every reform and intiative takes the NHS another step away from clinical contact.   Now there is a new lifeform of NHS bureaucracy that feeds on itself. Groups checking on other groups using a language devoid of all meaning and patient contact.    

The nadir of the process must be, we pray, the introduction of World Class Commissioning.   If you have ask what is world class commissioning, then you do not get it, and clearly you cannot enter the inner sanctum of NHS management.

That is the point.  It has no meaning.  It is what you want it to be.  
It is like the phrase “Clinical Governance” which had no definition when first coined,
but everyone assumed that they knew what it meant.  

World Class Commissioning is an astonishing edifice which has been constructed out
of management speak alone.  One of WCC's aims is the attempt to score Primary Care Trusts on their NHS purchasing abilities (commissioning).  In doing so, with top-down tick boxing, "WCC" has assured that local Practice Based Commissioning is given a final blow.  PBC was another initiative that was doomed from the start.

For the full extent of the verbiage produced in World Class Commissioning see the documents below.  Buzzword bingo cards would be filled up rapidly.  You are not being stupid if you do not get any of it. 

Quite simply The Emperor has no clothes. 

A local presentation to the board, a guide is a good instruction to the terminology of WCC, click this  WCC Presentation

The consultancy company that has jumped on the WCC bandwagon is Humana as seen at  and

Department of Health World Class Commissioning Site

World Class Commissioning Department of Health Document
Dr Gerard Bulger September 2008
Contact Gerard Bulger


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