Lord Darzi's NHS Report examined

The Committee sets out a number of conclusions and recommendations, including:

• The Committee warns that primary care trusts (PCTs) are not yet capable of carrying out the reforms and highlights insufficient analytical and planning skills and variable management quality within PCTs.
• Poor PCT commissioning and the failure of successive reforms to enhance it mean that implementation of the reforms may be slower and more uneven than expected.
• The Committee calls on the Government to publish and rigorously monitor milestones for each stage of implementation and says greater clarification is required on the role of practice-based commissioning, which at present remains opaque.
• More emphasis needs to be placed on the importance of recruiting and developing better managers and the issue of weak management skills in this area should be tackled.
• Not enough detail about cost is given in the Next Stage Review (NSR) and the Committee is concerned that neither Strategic Health Authorities (SHAs) nor the Department have been clear on where and how much money will be saved.
• Figures on implementation costs for individual SHAs and PCTs should be published as soon as possible.
• While the focus in the NSR on improving quality of care is welcome, variations in quality have been known about for a long time and have continued despite increased funding.
• The Committee is not convinced by the Department's argument that all PCTs should have a GP-led health centre and recommends that their creation should be decided locally on a case-by-case basis.

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