Compact in action: Primary care trusts

The local health authority is denting Warwickshire's reputation for Compact observance.

When voluntary organisations think about using the Compact to improve their relationships with the public sector, they usually think first of their ties with local authorities.

But links with primary care trusts are often every bit as important. "The amount of money health authorities spend on the voluntary sector to deliver health and social care services far outstrips the money given by local authorities in grants," says Charles Holmes, Warwickshire Compact officer.

Holmes has spent the past 18 months trying to get PCTs to take the Compact seriously. It hasn't been easy; when the Warwickshire Compact was reviewed in November 2005, only one of three PCTs in the county had signed up.

The three trusts merged to form the Warwickshire PCT last October, and Holmes hopes the new organisation will put pen to paper. "I'm a lot more confident now than I was 12 months ago," he says. "I've met the new leaders and they are very positive."

One hospital in the county, the George Eliot in Nuneaton, has signed the Compact, but the PCT is the main commissioner of services.

Many PCTs have chronic funding problems and are more preoccupied with balancing their books than establishing new relationships with charities. But Holmes believes that, if the Compact is to work, there has to be a more meaningful way of engaging with the health sector than by arguing until you're blue in the face.

"PCTs should be following the Department of Health's good practice recommendations - and if they are not, the Healthcare Commission should be doing something about it," he says.

Warwickshire is regarded as one of the more forward-thinking counties in terms of the Compact. That reputation is partially confirmed by the fact that Holmes' post as Compact worker is paid for by the county council. The PCT, however, has not yet even shown good intentions.

"Five district councils, one county council, the probation service and the police have signed up," says Holmes. "It is enormously important that the PCT signs up if we are to take the Compact forward in Warwickshire."

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