This paper sets out proposed arrangements to give GP practices commissioning budgets. from April 2005. The right to hold a budget is a first step towards the development of a sophisticated range of ways in which practices are involved in commissioning which support the principle of greater devolution. Practice based commissioning will assume greater importance in the NHS system overall. It will raise the profile of patient choice as a driver for quality and empowerment. Practises will be able to secure a wider range of services, more responsive to patient needs and from which patients can choose. From 2008 the impact of free choice for elective procedures will change the dynamic further. Practices could then use their commissioning abilities to identify alternative provision, including in primary care, to give patients greater choice.Patients will benefit from GP commissioning through a greater variety of services, a greater number of providers and treatment in settings that are closer to home and more convenient to patients. The NHS as a whole will benefit from more efficient use of services and greater involvement of front line doctors and nurses in commissioning decisions.
The Office of the Deputy Prime Minister has responded to criticism that there are deficits in generic leadership and change management competencies in local government technical management. Some 100 places are to be made available to ICT managers on the Future Leadership Programme run by Ashridge Management College. This is a self-development and leadership programme for mixed groups of senior managers from local authority service departments and other business areas. 1000 managers are expected to complete the three-module, 7 day, 3,500 pounds programme over the next twelve months.The ODPM and the Society of IT Managers have agreed on plans to embed e-Government and transformational change competencies into the Future Leadership Programme. This development recognises heads of ICT are frequently responsible for setting the strategic direction for e-government, as well as for developing the technical infrastructure and delivering operational services.
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Three quarters of central government departments have risk strategies in place for key areas, but many are not well developed, nor are they understood by staff. Training is lagging behind strategy development and a critical mass of staff have not yet developed skills and expertise to manage risks effectively. The National Audit Office in the report Managing Risk to Improve Service Deliver calls on departments to make effective risk management a central part of their day to day general management processes.The NAO, whilst applauding many examples of innovative approaches to risk and risk management, is concerned that public bodies are focused on developing a culture of active, explicit and systematic risk management. It wants decisions made by civil servants and other public officials to be routinely based around accurate and well informed judgements about risk.
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