Archive for April, 2009

Dental surgeries could extend opening hours

Posted on April 30, 2009. Filed under: Journals | Tags: |

Health Services Journal | By Helen Crump | 30 April 2009

Primary care trusts are to begin a £150m procurement process which could see dental surgeries opening outside normal hours.

National director for GP and dentistry access Mike Warburton said contracts for new work should focus on quality and access rather than activity and consider extended hours. PCTs would decide what hours were appropriate.

He said the money would be used for “additional procurement and new services” but did not have to involve a new building as last year’s GP led health centre procurement had done. No dental walk-in centres are proposed.

Tendering process

Dr Warburton said most investment would be in southern England, where shortages were greatest. PCTs will be expected to use tendering processes.

Dr Warburton denied that the change in emphasis in the contracting arrangements was an admission the present dental contract was not working.

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Pilot will boost patient role in GP service plans

Posted on April 30, 2009. Filed under: GP-led health centres, Journals | Tags: |

Health Services Journal | By Helen Crump | 30 April 2009

Private companies will tell GPs how to make their services more customer friendly under plans to boost patients’ role in shaping primary care services.

The Department of Health will seek bids for a pilot scheme to introduce the “very good patient centred processes” of the service industries into surgeries in the next month, national director for GP and dentistry access Mike Warburton told HSJ.

The DH also plans to double the number of patient participation groups and is considering giving GPs a statutory duty to consult patients on significant changes to services, he said.

“Primary care relies a lot on the good nature, willingness and values of staff. Some of the processes aren’t necessarily patient focused. The private sector has very good patient centred processes,” said Dr Warburton.

Primary care trusts will ensure practices get feedback from patients and deliver improved access through performance management visits.

Details will be in a world class commissioning guide for PCTs on access, due in July.

PCTs can use £50m extra cash to extend a contractual device called the directed enhanced service for access.

The DH will also launch a primary care service framework for investment in patient participation groups.

Dr Warburton said he hoped to influence another 30-40 per cent of practices to set up patient participation groups – at present, 40 per cent have them.

He said: “The greatest rewards will come from practices continually responding to the needs of their populations.”

Boosting patient group numbers and establishing networks across practice based commissioning consortiums could help PCTs hit their own world class commissioning patient engagement targets, he added.

Responsiveness to patients is the third area of a DH programme to improve GP services, after extending opening hours and establishing extra primary care services.

Of the 207 GP-led centres and new practices in under-doctored areas agreed so far under the programme, 42 per cent have gone to GP teams, 21 per cent to private companies, 17 per cent to consortiums and 14 per cent to the third sector.

Dr Warburton said the GP-led centres so far are averaging 1,000 visits a month: “While that isn’t full capacity, to start that’s fantastic. In the areas where they’ve opened early, that would demonstrate a real need.”

He said the British Medical Association’s anti-polyclinic campaign had actually raised public awareness of the facilities.

Patients were “smart enough” to know the extra services would not bankrupt GPs, he said.

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One in four GP led health centre contracts won by private sector

Posted on April 30, 2009. Filed under: GP-led health centres, News stories | Tags: |

Pulse | By Steve Nowottny | 19 January 2009

One in four of the new wave of polyclinics being rolled out across England has been won by private sector companies, Pulse can reveal.

The latest results of the tendering process show that 14 of the 54 GP-led health centre contracts so far announced have been won by private companies or groups led by the independent sector.

The wins represent a significant expansion of private sector primary care provision – and follow Pulse’s revelation last month that private companies had submitted almost 1,800 expressions of interest to run GP-led health centres.

But local GPs also performed strongly in the tendering process, with GP-led consortiums winning 30% of contracts and a further 7% being awarded to individual practices.

Among the private companies to make significant gains are Assura, who have won four joint contracts collaborating with local GPs in Coventry, Hartlepool, Bath and North East Somerset and Stockton-on-Tees, and Nestor Primecare, which will run centres in Herefordshire and Cornwall.

Dr Mark Hunt, managing director of Care UK, which is set to run two new centres in Brighton and Hove City PCT and NHS South East Essex, said private sector involvement in the procurement would benefit patients.

‘Care UK has a track record of working with PCTs across the country to provide high quality primary care services,’ he said. ‘These walk-in centres provide easy to access care to patients who have traditionally found it difficult to get access to the care they need when they need it.

But the strong performance by private companies comes just days after BMA chair Dr Hamish Meldrum – who hit the headlines earlier this month when it emerged his own practice had been part of a successful bid for a GP-led health centre in east Yorkshire – pledged to fight the Government’s ‘obsession’ with the commercialisation of the NHS.

He said: ‘It does strike me as bizarre that at exactly the same time as the Government seems to be taking the banks into public ownership, they are still trying to flog out parts of the NHS to the private sector.

‘The BMA will be continuing its fight against the commercialisation of the NHS and we’ll want your support in that fight.’

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GPs given contract for walk-in centre

Posted on April 30, 2009. Filed under: Uncategorized | Tags: |

Sunderland Echo | By Julie Wilson | Sunderland tPCT | 10 February 2009

Doctors who took over their own GP practice have been awarded the contract to run Wearside’s new walk-in centre.

Patients at Encompass Healthcare fought for two years to keep family doctors Ashley Liston and Tracey Lucas, amid fears that they could be forced out after the contract to run the surgery was put out to tender.

They were delighted when the GPs were chosen to run the practice at Washington’s Galleries Health Centre.

Now Encompass has won the contract for the new Washington Primary Care Centre, which will be open seven days a week, from 8am to 8pm.

It will provide a doctors’ surgery alongside a range of other mixed healthcare services, including a minor injuries walk-in centre.

Dr Liston, of Encompass Healthcare, said: “We are very happy and very enthusiastic about it. We are very committed to developing services for our patients.

“It’s going to be a huge asset for the local community.”

The walk-in service at the new Washington Primary Care Centre, in the town centre, will start from May 1, with additional GP services at Washington Galleries Health Centre from April 1.

Jan Forster, director of primary care commissioning for NHS South of Tyne and Wear, said: “We would again like to reassure patients that this is not about replacing current GP providers, but offering greater choice should patients wish to take up this opportunity.”

Sunderland Teaching Primary Care Trust has also announced that two new GP practices in Riverview Health Centre in Hendon and Pennywell Health Centre will be run by Peterlee-based Intrahealth from April 1.

The GP surgeries in Pennywell and Hendon will be open to new patients and will have a wider range of services and longer opening hours – 8am to 6.30pm and Saturday mornings – with a possibility that opening times will be extended even further.

Greg Moorhouse, managing director of Intrahealth, said: “We are extremely pleased and honoured to be given this opportunity. It’s something we are looking forward to.

“I’m a Sunderland resident and it’s a chance to make a difference in our own community.”

Mr Moorhouse, a pharmacist, said the shareholders of Intrahealth were from an NHS background. 

No suitable application was received to run a new doctors’ practice in the Coalfields area, so the trust is reconsidering its options.


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London announces first seven polyclinics

Posted on April 29, 2009. Filed under: Journals, Polyclinics | Tags: |

Seven polyclinics are open or will soon be open in London.

The health centres, which incorporate extended-hours GP services, were proposed by now health minister Lord Darzi two years ago.

His report on reforming the NHS in the capital, A Framework for Action, said five to 10 polyclinics should be developed by April 2009, but the policy was vehemently opposed by some GPs.

One of the centres, the Loxford Polyclinic in Redbridge, is “purpose built” and will open in June, NHS London said today.

The others – in Hounslow, Harrow, Lambeth, Tower Hamlets and Waltham Forest – are existing health centres that are extending their services.

All will offer extended-hours GP and other services, including pharmacy, diagnostics and urgent care. GPs based at the polyclinics and those at nearby practices will refer to their services.

Improving access

NHS London, which is pursuing the Framework for Action proposals with primary care trusts and providers through arm’s-length organisation Healthcare for London, said they would improve access and help reduce accident and emergency attendances.

Tom Coffey, a GP in Wandsworth and clinical director for the polyclinics programme, said: “I believe the new polyclinics provide a major leap forward in the story of London’s healthcare.

“Polyclinics will continue to develop over time and will be evaluated to ensure they meet the needs of local people and inform the development of future polyclinics.”

Healthcare for London programme director David Sissling added: “London has the worst GP access figures in the country. Polyclinics are a vital solution in making GP and other health services more user-friendly.”

NHS London chief executive Ruth Carnall said: “Polyclinics will transform primary and community care in London for the better, delivering accessible, high-quality services which will ultimately reduce health inequalities.”

Lord Darzi’s original report said: “New facilities – polyclinics – should be developed that can offer a far greater range of services than currently offered in GP practices, whilst being more accessible and less medicalised than hospital.”

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PCTs urged to promote more switching of GP by patients

Posted on April 29, 2009. Filed under: News stories | Tags: , , |

Pulse | By Steve Nowottny | 27 April 2009

The NHS been advised by management consultants to ramp up competition between GPs by providing each patient with a choice of up to five local practices.

A briefing document by Ernst and Young, circulated to PCTs by Government policy body NHS Primary Care Contracting, concludes a high level of patient ‘churn’ is essential to ensuring healthy competition.

One PCT chief executive argued that patients should be able to switch GP as frequently as their gas or broadband supplier.

The new advisory document comes a month after a series of SHA assessments of PCT commissioning skills found even those that had embraced APMS had failed to sufficiently open up the primary care market.

The Ernst and Young briefing, sent to all PCTs, argues ‘competitive tension’ is key to ensuring quality, and sets out a series of ‘market management levers’ trusts can use to encourage greater rivalry among providers in both primary and secondary care.

Patient switching, defined as ‘the ‘churn’ in a market’, is identified as a key indicator of competition, with switching of up to 60% in some markets described as ‘optimal’.

‘Switching provides the stimulus for providers to improve or maintain quality of service,’ the guidance states.

Dr Sarah Crowther, chief executive of Harrow PCT, told policy makers at a Westminster Health Forum event: ‘The level of switching we see between practices is still very limited.

‘Our population changes its gas supplier or its broadband supplier more readily than its local GP. That has to be something we as a PCT try to promote.’

But Dr Fergus McCloghry, chair of Harrow LMC, reacted angrily to the comments, which he said would further reduce patients’ continuity of care.

‘It’s another attempt at undermining what’s good about general practice,’ he said.

‘There is no doubt if a patient’s unhappy they should change, but not it’s just a question of changing doctors for the sake of changing.

‘What you get from one doctor is not going to going to cost more or less than what you get from another doctor because you’re not paying.’

ERNST AND YOUNG GUIDE FOR PCTS: UNDERSTANDING HEALTHCARE MARKETS

  • PCTs need to define healthcare markets and consider the current state of competition – including market segmentation, geography and competition type
  • Trusts should assess market dynamism – specifically looking at the number of providers offering choice, market concentration, proportion of patients switching and rivalry between providers
  • PCTs should draw up market priorities and then deploy a range of market management levers, including publishing greater comparative information between providers, altering key performance indicators and where necessary decommissioning existing providers
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GP-led health centres threaten OOH funding

Posted on April 29, 2009. Filed under: GP-led health centres, News stories | Tags: , |

Pulse | By Steve Nowottny | 29 April 2009

NHS managers are beginning moves to renegotiate contracts for out-of-hours services because of a fall in demand since the launch of GP-led health centres.

An evaluation at one of the first of the centres in the country to open has found large numbers of patients are choosing to use it rather than the local out-of-hours provider.

Primary care academics are predicting that the value of out-of-hours contracts could fall sharply because of the heavy overlap with GP-led health centres in the early evening and particularly at weekends.

Managers at NHS Northamptonshire reported that patients seeking care at the weekends had been flocking to the walk-in facilities at the new Darzi centre.

The PCT reported a ‘marked decrease’ in out-of-hours attendances in the town of Corby since the Lakeside Plus GP-led health centre opened in early December.

And it has wasted no time in trying to re-negotiate the levels of funding for out-of-hours care. The trust is currently tendering for a new out-of-hours provider and said it would be trying to drive down the cost of the contract.

Nicki Price, associate director, Primary Care Contracts and Market Development at NHS Northamptonshire, told Pulse: ‘We absolutely expect to see an impact in what we pay for the out-of-hours services as a result of the 8-8, because obviously there’s activity shifting around the system.

Professor Chris Ham, professor of health policy and management at the University of Birmingham, said he believed other out-of-hours providers would face similar pressures:

‘I predict two scenarios. For some patients who are not currently able to access services, these will be additional and generate more demand.

‘For other patients, it will be a diversion from services that they otherwise would have used, such as their own GP practice, out of hours and A&E taking pressure of hospitals for cases that are more appropriately dealt with by these GP services.

Walk-in numbers at the Northamptonshire centre have been far higher than expected, with a total of 1,201 patients in March compared with an estimate of just under 700.

But Ms Price said the centre had only registered around 250 patients by the end of March – compared with a projected 500 – partly because a local house-building programme had stalled due to the recession.

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GPs beat companies to contract for APMS

Posted on April 29, 2009. Filed under: News stories, Providers | Tags: |

GP in Healthcare Republic | 6 July 2007

A small, local but ‘very experienced’ GP-led provider has seen off competition from multi-national companies to win a £900,000 APMS contract to run three practices in Leeds.

Leeds PCT has appointed One Medicare, led by Wakefield GPs Dr Phillip Earnshaw and Dr Patrick Wynn, to take over GP provision at the Hilton Road Surgery in Chapeltown and Shafton Lane Surgery in Holbeck as well as setting up a GP surgery at The Light in Leeds city centre.

One Medicare won the contract from a field of 22 applicants. Leeds PCT would not comment on the other bidders.

Salaried GPs will be employed to work a normal day at the existing surgeries at Chapeltown and Holbeck. GPs at The Light will work an extended 7am-7pm day and Saturday mornings to fit in with the walk-in centre in the same building.

‘Patients will typically be young professionals and our opening times will be geared to patient demand,’ said Rachel Beverly-Stevenson, chief executive of One Medical, the primary care property developer that jointly owns One Medicare with FMC Health Solutions.

One Medicare is contracted to provide level-two local enhanced services for mental and sexual health at The Light.

Dr Earnshaw, chief executive of One Medicare, said the APMS contract was not significantly different from the PMS contract he works under as a GP in Wakefield.

‘Our APMS contract reflects how we would operate a standard GP contract,’ he said. ‘The way it is presented as a table of key performance indicators is different, but what the PCT is asking differs very little from our own performance-related PMS contract.’

Dr Earnshaw set up FMC Health Solutions, a limited liability company, with his partner Dr Wynn to run a three-site practice at Ferrybridge Medical Centre in Wakefield.

Three quarters of APMS contracts to date have been awarded to entrepreneurial GPs ahead of private providers, according to researchers from the King’s Fund (GP, 16 February 2007).

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Polyclinics threaten 600 GP practices, say Tories

Posted on April 29, 2009. Filed under: GP-led health centres, News stories, Polyclinics |

Telegraph | By Kate Devlin Medical Correspondent | 18 June 2008

More than 600 GP practices are under threat because of Government plans for “super surgeries” despite overwhelming public opposition to the proposals, according to the Tories.

Hundreds of family doctor surgeries across England have been identified by local health Trusts as being in the same catchment area as proposed new polyclinics.

The Conservatives have compiled the list of practices across the country, named in plans for polyclinics drawn up by Primary Care Trusts, which they say could be killed off by the scheme.

They said the list showed practices which could be forced to shut because they would lose patients to the new clinics if they went ahead and warned that the final figure is likely to be much higher as many Trusts are still compiling plans.

Doctors who found their name on the list would now be “even more concerned than they were already” about the possibility of closure, the British Medical Association (BMA) said.

But the Government insisted that there was no suggestion in the documents that any of the practices had been earmarked for closure.

Last week more than 1.2 million patients signed a petition protesting against plans for polyclinics, which was delivered to Gordon Brown.

Doctors’ leaders argue that the new surgeries will destroy the relationship between patients and their GP family doctor and force them to travel much further to see a doctor.

GPs are also worried that polyclinics could “cream off” younger, healthier patients who help to subsidise their practices to treat those with more complex medical problems.

But ministers insist that the clinics, which could house up to 25 GPs as well as extra services such as dentistry and minor surgery and will open during evenings and weekends, will provide a “world class” service.

The Tory research reveals that 608 practices in almost half of all Primary Care Trusts outside London -where ministers insist that the “GP led health centres” will be in addition to existing services – have already been listed as close to proposed new clinics.

If this were replicated across the rest of the country including the capital as many as 1,700 practices could be under threat.

The Tories said the implication was that polyclinics would threaten the viability of the practices listed, even if not all of them would be forced to shut.

Andrew Lansley, the Conservative health spokesman, said: “The Government needs to explain why these GP surgeries are being named if it’s not because polyclinics pose a threat to the local doctor.

“It adds to the huge weight of evidence now building up that polyclinics are not the additional services as Gordon Brown has claimed. Patients and family doctors are right to be worried about losing a valued local service. It’s time

Labour faced up to their concerns and called a halt to their unpopular polyclinics scheme.”

A spokesman for the BMA said that the publication of the list would worry GPs already concerned that their practices could shut.

He said: “We have always had concerns about the viability of practices that are close to these polyclinics.

“It is inevitable that they will lose resources because of the new development, even if they are not actually dragged into it.

“Ben Bradshaw [the Health Minister] has said that some patients won’t have to deregister with their GP to use this service, but that is not really the point.

“There is only one pot of money and if it is all going into polyclinics then GP surgeries will have to cut back on services and many could be forced to close.”

He added: “GPs who find themselves on this list will be even more concerned than they were already.”

But the Government insisted that the Tories had got their “facts wrong” on the issue.

Mr Bradshaw said: “This summer’s Tory health campaign against more flexible GP opening hours is as ill-fated as last summer’s against hospital closures. David Cameron was humiliated into abandoning last year’s campaign when he had to admit the Tories had got their facts wrong. They’ll be forced to abandon this one when they realise they’ve got their facts wrong again.

“The public like being able to see a GP in the evenings and at weekends. Once again, the Conservatives are firmly on the wrong side of the argument on health.”

An official spokesman for Mr Bradshaw said: “There is no suggestion from any of those PCTs that these surgeries are marked for closure.”

Meanwhile the Department of Health announced that more GP practices than ever were opening for longer.

For the first time, 20 per cent of practices offer extended opening hours in the evenings and at weekends, up from just 12 per cent in April. In some Trusts more than half of all doctors offer out of hours appointments at their clinics.

By the end of this year the Government wants at least 50 per cent of all GP surgeries to offer extended opening hours.

Within London, where ministers insist plans for polyclinics differ from the rest of the country, around 100 practices have already been already earmarked for closure, to make way for the new surgeries.

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New GP Surgery and Walk-in Service in Rotherham Open

Posted on April 29, 2009. Filed under: GP-led health centres, Press/News Releases | Tags: , |

Care UK | 4 June 2009

Two new health services, run by Care UK on behalf of NHS Rotherham opened this week on 1st June . An entirely new GP surgery, Chantry Bridge Medical Practice, will start treating and registering patients this week. Care UK has also taken over the running of the Rotherham NHS Walk-in Centre, and is now offering extended opening hours from 8am to 9pm, 7 days a week.

Both services are situated at the Rotherham Community Health Centre, so patients can choose to register at Chantry Bridge Medical Practice or can attend the Rotherham NHS Walk-in Centre whether they are registered with a GP or not, as they do not need an appointment to get treatment at the Walk-in service. Care UK is extremely pleased that this new facilities have opened, as they provide local people with greater choice about how they access healthcare, in a way that is convenient to their lives.  

Care UK now operates 10 GP surgeries and Walk-in centres across the UK, fulfilling people’s lives by providing high quality health care to thousands of people in a way that is easy to access and convenient. 

Both services offer easy access with some free onsite parking and extended opening hours. Patients will be seen at the Rotherham NHS Walk-in Centre from 8am-9pm every day except Christmas Day, while Chantry Bridge Medical Practice will also be open from 8am-8pm Monday to Saturday.

Mark Hunt, Managing Director of Care UK Primary Care said: 

“Care UK is delighted that these new facilities have opened, giving access to high quality health care to the people of Rotherham. Through our partnership with NHS Rotherham, the facilities will provide medical services to anyone, from 8am to 9pm seven days a week, meaning that everyone in the area will benefit from these new services, and will have greater choice about how they wish to access healthcare facilities and treatment.  These services are in addition to the diagnostic services that we already offer in the Rotherham Community Health Centre.

 “The facilities are now open, so I would encourage anyone who is in need of healthcare to drop in, whether they are registered with a GP or not, as the walk-in service is available to everyone on a first come first served basis. 

“Care UK has an extremely high standard of care in our GP practices and Walk-in centres across the country, with 94% of our patients rating our Walk-in centres as either good or excellent. We are confident that the care at the new service in Rotherham is of a similarly high standard. Care UK look forward to continuing to work in partnership with NHS Rotherham bringing easy to access, high quality health care to local people.”

Patients looking to register with the new GP practice, or to make an appointment, can contact Chantry Bridge Medical Practice on 0333 200 4054 or find more information at http://www.chantrybridgemedicalpractice.co.uk

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Integrated care organisations and their vital PBC role

Posted on April 29, 2009. Filed under: Integrated care, News stories |

Pulse | Practical Commissioning | Interview by Miranda Griffin  | 29 April 2009

integrated_care_circle_of_people___alamy___single_use_onlyThe announcement this month of the final 16 integrated care pilots has put ICOs in the limelight – but ICOs are about more than the pilots, as Dr Oliver Bernath explains.

1. Define an ICO for me
Well, the first thing to stress is that being an integrated care pilot does not mean you are actually an integrated care organisation.

The DH integrated care prospectus was very relaxed about the criteria for what could be an integrated care pilot – the pilots had to be based on a registered patient list and have the local PCT’s approval.

The prospectus talked of teams of primary and secondary care clinicians, or health and social care professionals who might be based in the same place or employed by the same organisation and also said integration might possibly involve bringing together resources. Again it was non-specific on the means to pool resources but said this could include delegation to providers of a risk-adjusted capitation sum for a group of registered patients. This would be an integrated care organisation.

Looking at the scope of the newly announced national pilots, I would say they only address narrow slivers of the totality of care – urgent care, elective care, community care, prescribing, primary care. But none of the pilots seems to cover the whole spectrum of care.

2. Do you need integrated care organisations then?
My view is that you need to go for the whole lot – one service, one team, one budget to strengthen the whole patient focus, otherwise we end up with the balloon problem…. squeeze it in one place, only to see the problem pop up elsewhere. We want to have the whole balloon in our hands so that we cannot shift a problem from one area into the other – if we do, inadvertently, we still have to live with the consequences.

So, to me an integrated care organisation is a provider organisation that takes on the PBC budget together with GPs but has a real contractual obligation – the ICO takes on a capitated delegated sum at risk and delivers to the commissioner whatever outcomes and services they want to see. It helps providers to organise themselves without needing to become employees of one company. This way GPs can stay as independent practices.

GPs are the lynchpin of all this as they hold the patient list and have a gatekeeper function for the whole healthcare market.

ICOs have a total pathway view. For example, at the moment a GP knows what care an asthma patient receives in their practice, the hospital knows what care the patient receives with them, but nowhere is it all pulled together and that makes it difficult to see which points of that patient’s care need improvement.

As well as the management capability, ICOs would also provide the analytic capability to map and track entire care pathways with all costs and benefits – both outcomes and patient experience. This can become quite IT-heavy as you need information systems that can enable that analysis not only a year in retrospect but also at the time something like an admission happens.

ICOs would also provide capital, first to buy equipment but also to provide underwriting cover for the overspend risk that is too large for a GP practice to carry.

3. Where has this concept come from?
This type of organisation has not been seen before in the UK, but the need comes from both clinicians and patients.

As a consultant neurologist I felt great frustration receiving referrals where, if I had been involved earlier, I could have prevented half the complications, and when I sent the patient back to the GP I had no further influence. It was an isolated care episode rather than a longitudinal one.

GPs have the same frustrations – it takes a long time to access a consultant’s expertise, the outpatient appointment often takes a long time to come through, then after the consultant has seen the patient the GP gets a letter back that may not address what they felt the problem was. The patient has to navigate the whole healthcare system themselves as they are the only person who sees the whole picture.

The current fragmented system doesn’t really work for patients – when unnecessary complications arise, it is bad for patients and is a drain on healthcare resources.

PBC is a start but it is just the first step of a longer journey. There is not enough transparency around how the budget numbers come together so GPs don’t know how to influence it. Nor do GPs really have the freedom, tools or power to shape it. As

a result it has caused a lot of frustration. ICOs are the next step for PBC, though the need for practices to be like-minded is far greater than geography. The practices involved need to be high-performing and innovative to take this on. There is also scope for the ICO to contain practices from different consortiums and for some practices in the consortium to stay outside the ICO.

4. Why should commissioners be interested when there are so few ICO pilots?
We have started our own pilot outside the national programme with a wide range of initiatives covering the whole range of care. This can be done under the existing PBC

set-up if your PCT is willing. The national pilot programme prepares policy development but it doesn’t stop anyone else from going it alone. We felt we could get more quickly from the pilot stage into the proper ICO stage by going it alone.

5. Why is the patient list so central to ICOs?
If you were to allow a provider to select their patients, they could cherry-pick the young healthy ones and pass those with chronic conditions back to the NHS. The NHS would be stuck with the high-cost population.

Also, if you had specialist providers for different disease categories – for example a specialist organisation for diabetes care – you would be taking apart what primary care is trying to pull together. The commissioner would be paying the GP a fixed amount per registered patient and also paying the specialist provider for diabetes care, so would either be paying twice or would take the money for diabetes care away from the GP.

If the same approach is taken with other conditions you eventually disaggregate the whole primary care package. Then you have no need for a GP and end up in the situation where the patient is looked after by all these specialist providers and nobody looks after the whole patient any more. Also, it would be impossible to allocate a budget if you didn’t have a population base to base it on.

6. What about the provider- commissioner conflict? ICOs seem to blur lines even further.
When a GP sends the patient to a cardiologist are they subcontracting a piece of care or commissioning? This is where the grey zone is but it already exists and is inextricably linked to the job of the GP.

The conflict arises if the GP has a financial interest in influencing patient choice. It may be that the GP’s relationship with the cardiologist is actually good for patient care but the conflict of interest would have to be declared and the profits mitigated.

In my vision, first there has to be full transparency. If the practice has its own cardiologist, it has to tell the patient the appointment might be faster but it has to declare the relationship with the cardiologist.

Second, if provider organisations are not-for-profit community interest corporations where the service gets paid for fairly but there is no additional profit, then the financial interest is just one of providing the best service at the cheapest cost and there is no conflict.

7. Do practice-based commissioners have a choice not to get on the ICO train? What will happen if they don’t?
ICOs will have to prove they are not underspending on patient care to maximise profit and that patients will receive at least as good care, if not better, than they would elsewhere.

GP practices that don’t like being scrutinised are not suited to being part of an ICO. However, I feel most practices that are proactive and proud of what they do will sooner or later join the ICO bandwagon. The practices left behind will probably be the ones that don’t want to engage, or whose GPs are close to retirement or afraid that their standards are not as high as the ICO would demand.

Then the challenge from the PCT’s perspective is to examine how to motivate those practices and what consequences the underperforming practices would have to face. The failings of some practices, which have always been there, will become more obvious.

8. What will happen if we have a change of Government? The Conservatives seem cold on ICOs because of the commissioner/provider split.
Andrew Lansley has said he thinks it is not necessary to create new organisations. In a sense I agree. We do not need something to replace GP practices or hospitals, you do not need a new provider organisation, but you still need a different level of management that understands the total care of the patient across the different providers, and something to help with the systems integration and to make the information flow better, and somebody to take on the financial risks.

Dr Oliver Bernath is managing director of Integrated Health Partners

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Save the NHS from profit-making private companies

Posted on April 28, 2009. Filed under: Reports/papers | Tags: |

Politics of Health Group | 19 April 2009

The government has set up a new body, the Cooperation and Competition Panel to accelerate the carve up the health service by intervening on behalf of aggrieved private-sector companies to force Primary Care Trusts to put services out to tender and prevent NHS trusts co-operating to provide a comprehensive service for local people.

We have a chance, through the “consultation” process (which ends on 30 April), of rejecting the Panel’s plans, which would hold up the government’s gallop towards NHS privatisation.

The Keep Our NHS Public campaign does not believe the consultation is a true consultation as it fails to ask stakeholders their opinion on the most important question of all – whether Primary Care Trust services should be provided by private companies and voluntary sector bodies, or should most effectively in terms of quality and cost continue to be provided directly by the National Health Service.

   1. If you are a GP or a patient in a GP surgery,
   2. A Keep Our NHS Public (KONP) member,
   3. A Local Involvement Networks (LINks) member

The consultation documents are online at http://ccpanel.org.uk/reports-and-guidance/guidance-documents.html <http://ccpanel.org.uk/reports-and-guidance/guidance-documents.html> together with a form in which you can make your response.

In Section 9: GENERAL QUESTIONS in the documents you should respond to two questions in particular numbered 5 and 6 (do of course respond to any of the others as well):

Question 5. Do the guidance documents have any significant omissions; if so what?

“You have not given any evidence that commissioning out PCT services to the private and independent sectors is better than retaining them in the NHS in terms of either quality (the most important issue) or cost. You simply assert that competition is good and must inevitably result in better services. Where is your evidence for this?”

Question 6. Does the guidance cover all relevant matters, insofar as these can be identified; if not, what additional material should be included?

“You must consult on whether the British public want to see NHS services privatised and sold off to big private health care companies which are primarily interested in profits for shareholders and not in the quality or cost-effectiveness of services.
“You must provide evidence as to why these private profit-seeking companies should be seen as “world class”, and what appropriate skills and knowledge they have to offer NHS organisations tasked with delivering a universal and comprehensive health care system to the whole local population.”

Send your response to the Cooperation & Competition Panel Interim Guidelines Consultation, Cooperation and Competition Panel, 1 Horse Guards Road, London SW1A 2HQ UK or consultations@ccpanel.gsi.gov.uk <mailto:consultations@0ccpanel.gsi.gov.uk>

Remember – the consultation process finishes on 30 April.

Bronwen Handyside
KONP Campaign Manager

Department of Health formal response to the Cooperation and Competition Panel consultation

30 April 2009

The Cooperation and Competition Panel (the Panel), chaired by Lord Carter of Coles, opened for referrals on 30 January 2009. The Secretary State established the Panel to help ensure NHS-funded services support the delivery of high quality care for patients and value for money for taxpayers.

Since they became operational, the Panel has been consulting on their draft operating guidelines, which outline how the Panel will do business with the NHS. The aim of this consultation was to seek the views from interested parties on whether the four guidance documents covering procurement disputes, appeals on advertising, anticompetitive conduct and mergers were clear, comprehensible and analytically sound.

As a sponsor and major stakeholder, the Department of Health formally responded to the Panel’s consultation. The Secretary of State has strongly welcomed the consultative and iterative approach the Panel has taken to develop the guidelines. We are confident the Panel, in making its recommendations, will help ensure that cooperation and competition in the NHS supports the objective of delivering high quality care for all.

The role of the Panel will complement and support the role undertaken by Strategic Health Authorities (SHAs), as the regional system manager. It is essential that the Panel maintains constructive working relationships with the SHAs and seeks representations from them during the course of all their investigations.

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Recession forces Chilvers McCrea to drop APMS contract

Posted on April 28, 2009. Filed under: News stories, Providers | Tags: , , , |

Pulse | By Gareth Iacobucci | 28 April 2009

A squeeze on bank lending is forcing private providers to ditch APMS contracts, Pulse can reveal.

Chilvers McCrea Healthcare, which manages over 30 practices across the UK, has been forced to terminate its contact to run an APMS practice in Essex because of the tough economic climate.

It is the latest in a series of private sector withdrawals from primary care which appear to pose a serious threat to the Government’s drive to ramp up competition.

The company’s decision to stop running the Pier Medical Centre in Southend, which includes two surgeries, comes just weeks after its chair, Dr Rory McCrea, warned GPs would find it increasingly difficult to make a profit on APMS contracts.

South East Essex PCT is now having to search for a new provider for the contract, which runs out in 2010.

Dr McCrea told Pulse: ‘Due to the current economic climate, it was not sustainable for Chilvers McCrea Healthcare to carry on the contract to manage the practice.

‘Chilvers McCrea, like many companies across all sectors, is debt funded and currently banks are going through a period of being nervous about lending.’

A spokesman for the PCT said: ‘ChilversMcCrea is continuing to deliver services until 2010. During this time we will secure a new provider through the procurement process to ensure there is a seamless transfer of services.’

The move comes after private firm Atos Healthcare recently pulled out of running an APMS practice in Berkshire due to the financial climate and low demand for services.

Both Atos and United Health also dropped out of the running for a tender in Sheffield prior to the award of the contract.

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New GP services vital to improve local health says Trust

Posted on April 28, 2009. Filed under: GP-led health centres, News stories |

Rochdale Online | 5 June 2008

Bringing more GP’s into the Rochdale Borough is essential to improving the health of the local people, say bosses at Heywood, Middleton and Rochdale Primary Care Trust (HMRPCT). 

Earlier this year the PCT announced that it will be funding for three new GP Practices to be located in Heywood, Central Rochdale and Smallbridge & Wardle, as well as a new GP-led Health Centre in Middleton. 

These new GP services are in addition to the 35 practices currently in operation within the Rochdale Borough. The PCT recognises the high standard of work currently being provided by local GP’s and the new services are being introduced to provide more health care in the Borough. They will not act as a replacement for practices already in operation.

“We have chosen to locate the new GP services in the areas that have the poorest health and are significantly low numbers of doctors,” says Vivienne Ben-David, head of Primary Care at HMRPCT. 

“The Borough has a number of health inequalities that we must address. A person living in Central Rochdale today will die 13 years younger than somebody living in Norden. Around 22,000 people in the Borough have undiagnosed high blood pressure which can cause cardiovascular disease. These are just some of the health issues that we need to tackle and having additional manpower will make a big difference. 

“The reality is that the Rochdale Borough has one of the lowest numbers of doctors in the country and findings from the GP Patients Survey show that our patients feel that they cannot access GP services easily. International evidence shows that with more doctors, quality of care increases and less patients are admitted to hospital. Therefore, the new GP services we plan to provide are essential to boosting existing services and reduce the number of patients each doctor needs to see. This means all of our doctors- existing and new- will have more time to identify health problems and treat patients, tackling the key health issues we have in the Borough. 

”As well as treating illness, we want to work towards preventing ill health and improving people’s lifestyles. We will do this by working with local GP’s and the Council to help people live longer and healthier in all areas.” 

Rochdale Council’s Cabinet member for Health and Social Care, Councillor Dale Mulgrew is supporting the PCT’s plans and is involved with the project. He said: “The new GP services will be going into the areas which really need them so there is no need for people to worry about what might happen to existing GP practices – we need as many GPs as we can get. It is a real boost for the Rochdale Borough and RMBC will continue to work in partnership and collaboratively with the PCT to find ways of improving the health of our population.” 

The new GP surgeries and health centre will offer all of the regular services you would expect from a GP practice. The main difference is that they will also provide a range of additional services tailored to the needs of the local population, and will be open for longer. A range of organisations are eligible to run these new services and the PCT is currently undertaking a detailed tendering process to choose the most suitable provider. 

To ensure the needs of the local population are met, the PCT is inviting patients and the public to take part in its biggest ever consultation to help decide what these additional services should be, how the practices should be managed and how patients can use and access the services. 

John Pierce, chairman of HMRPCT, added: “The Rochdale Borough has some of the poorest health in the UK. If we really are going to improve the health of the local people then we definitely need new GPs and services to help us do it. If the existing services were enough, then we wouldn’t have the massive health issues we have today. 

“I urge local people to get involved in the consultation and tell us what would make a difference to their health so that the new services are as effective as possible.” 

You can take part in the consultation by completing the postal feedback form distributed to households, completing the feedback form online by email or by post. 

Email: patient.publicinvolvement@hmrpct.nhs.uk 

Web: www.hmrpct.nhs.uk/your_services/new_gp_practices/feedback_form.asp

Tel: 0800 121 4406

Or write to: 
PALS 
HMRPCT 
Freepost NEA15390 
Rochdale 
OL16 1ZZ

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GP-LED HEALTH CENTRE OPENS AT WESTON GENERAL HOSPITAL

Posted on April 26, 2009. Filed under: GP-led health centres, Press/News Releases |

NHS North Somerset | Media Release | 26 March 2009

A new GP-led walk in centre at Weston General Hospital formally opens its doors to patients tomorrow (Friday 3 April).

The £1million Weston GP Healthcare Centre, which will be officially opened by NHS North Somerset Chairman Stephen Harrison, offers a full range of GP services to registered patients, and urgent care to anyone who wishes to use it, whether or not they are registered with a GP elsewhere.

Appointments will not be necessary and the centre will serve the needs of residents and holiday visitors like. It will also be a valuable additional service for the growing population of migrant workers in and around Weston.

The new centre is open for 12 hours a day, every day of the year. It plays an important role in providing improved access to comprehensive primary care services.

Later this summer the service will be extended to a new GP facility in Weston town centre. There will also be new GP practice opening in Worle, an area of high population growth and where existing practices have high list sizes.

NHS North Somerset announced plans for the two new health centres at the end of last year, in the wake of Health Minister Lord Darzi’s report on primary care which called on every PCT in England to establish a GP Led Health Centre, open for 12 hrs per day.

The Weston GP Healthcare Centre will provide the full range of primary health care services for people who have, in the past, found it difficult to register with a GP – for example through difficult and irregular working hours or because they were part of a travelling or migrant community.

NHS North Somerset Chief Executive Chris Born said: “This is great news for the people of Weston and Worle. We can now get down to delivering the new services which will improve access to first class family health care.

We are very pleased this will provide a better service to people who may not have been able to use a GP practice before.

“Anyone with an illness or symptoms about which they are concerned can simply walk in and see a GP or nurse, although fractures and other injuries will be dealt with at the nearby accident and emergency department at Weston General Hospital. People can also register with the centre and we anticipate that it will have a list of 2,500 registered
patients within five years.”

*** PHOTOCALL OPPORTUNITY ***
There will be an opportunity for filming at the centre, including interviews, and a photocall with the nursing and GP staff at the centre.

When: 3 April – time to be confirmed
Where: Weston GP Healthcare Centre, Weston General Hospital. On coming through the main hospital entrance, please bear to the right and follow the blue signs.

[ENDS]

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GP led health centre contract is signed

Posted on April 26, 2009. Filed under: GP-led health centres, Press/News Releases, Providers | Tags: |

Worcestershire PCT | Press Release | 26 March 2009

Health chiefs at Worcestershire Primary Care Trust and the directors of the
company appointed to run the county’s new GP-led Health Centre have
sealed the deal this week by signing the official contract.
The PCT announced in December that Elgar Healthcare – a consortium of
local GPs – had been named as the preferred bidder to run the new centre
due to open in August 2009.
When the centre, which will be located in Farrier Street, Worcester, opens, it
will mean that anyone can access GP appointments without having to be
registered, bringing health and wellbeing to people with busy, active lives who
can’t necessarily always find time to attend their own GP practice.
The GP-led Health Centre will be open from 8 am till 8 pm all 365 days of the
year, providing all usual General Practice services for all members of the
community with an emphasis on improving access to those sections of the
population who tend to access services poorly.
Helping people stay well and healthy is a key priority for all working in
the new Health Centre and some of these services will also be provided in
other parts of the City.
Brian Hanford, Director of Finance at Worcestershire PCT, said: “This
exciting development is part of our overall strategy dedicated to the
improvement of access to primary care services. We are delighted to be in
partnership with Elgar Healthcare and look forward to working with them in the
delivery of primary care services, which will include the opportunity to see a
GP without a prior appointment.”
Dr Adam Thompson, Director of Elgar Healthcare Limited, said: “Having
completed contract signature, we are looking forward to working with the
PCT to deliver an innovative way of delivering General Practice.
“Our company has been formed by local doctors, and we anticipate that
our local knowledge and expertise will assist us in delivering a high quality
service, which can focus on the health needs of our local community.
“The service aims to provide appointments for people for busy lives who may
not normally get to see their own GP with routine problems, rather than
supplement the Primary Care Out of Hours Service, and is therefore designed
to be complimentary to existing General Practice Surgeries in the county
which already have high standards of care delivery.
“The centre will also focus on attracting groups in the community to
whom healthcare has not always reached out to for a variety of reasons.
We also aim to bring additional health education and screening to the
community as the service develops.”
ENDS
For further information contact
• Rebecca Bourne, Communications Manager, on 01905 760020 or 07775
816420 or email rebecca.bourne@worcspct.nhs.uk
• Tom Grove, Communications Officer, on 01905 733734 or 07501 484255
or email tom.grove@worcspct.nhs.uk

Health chiefs at Worcestershire Primary Care Trust and the directors of the company appointed to run the county’s new GP-led Health Centre have sealed the deal this week by signing the official contract.

The PCT announced in December that Elgar Healthcare – a consortium of local GPs – had been named as the preferred bidder to run the new centre due to open in August 2009.

When the centre, which will be located in Farrier Street, Worcester, opens, it will mean that anyone can access GP appointments without having to be registered, bringing health and wellbeing to people with busy, active lives who can’t necessarily always find time to attend their own GP practice.

The GP-led Health Centre will be open from 8 am till 8 pm all 365 days of the year, providing all usual General Practice services for all members of the community with an emphasis on improving access to those sections of the population who tend to access services poorly.

Helping people stay well and healthy is a key priority for all working in the new Health Centre and some of these services will also be provided in other parts of the City.

Brian Hanford, Director of Finance at Worcestershire PCT, said: “This exciting development is part of our overall strategy dedicated to the improvement of access to primary care services. We are delighted to be in partnership with Elgar Healthcare and look forward to working with them in the delivery of primary care services, which will include the opportunity to see a GP without a prior appointment.”

Dr Adam Thompson, Director of Elgar Healthcare Limited, said: “Having completed contract signature, we are looking forward to working with the PCT to deliver an innovative way of delivering General Practice.

“Our company has been formed by local doctors, and we anticipate that our local knowledge and expertise will assist us in delivering a high quality service, which can focus on the health needs of our local community.

“The service aims to provide appointments for people for busy lives who may not normally get to see their own GP with routine problems, rather than supplement the Primary Care Out of Hours Service, and is therefore designed to be complimentary to existing General Practice Surgeries in the county which already have high standards of care delivery.

“The centre will also focus on attracting groups in the community to whom healthcare has not always reached out to for a variety of reasons.

We also aim to bring additional health education and screening to the community as the service develops.”

ENDS

For further information contact

• Rebecca Bourne, Communications Manager, on 01905 760020 or 07775

816420 or email rebecca.bourne@worcspct.nhs.uk

• Tom Grove, Communications Officer, on 01905 733734 or 07501 484255

or email tom.grove@worcspct.nhs.uk

Worcestershire PCT appoints Elgar Healthcare to run new GP-led health centre

Worcestershire PCT | Press Release | 23 December 2008

Worcestershire PCT is pleased to announce the preferred bidder who has today been appointed to manage and run a GP-Led Health Centre in Worcester.

The PCT had interest from a number of potential providers and Elgar Healthcare has been selected following a rigorous selection process The PCT is now working with Elgar Healthcare Limited -a company founded by local GPs – to develop new ways of providing healthcare services in Worcestershire.

The GP-led Health Centre will be situated in Farrier Street, Worcester and is due to open by July 2009.

When it opens, it will mean that anyone can use the health centre without having to be registered and will focus on bringing health and wellbeing to people with busy, active lives who can’t necessarily always find time to attend their own GPpractice.

The GP-led Health Centre will be open from 8 am till 8 pm all 365 days of the year, providing all usual General Practice services for all members of the community with an emphasis on improving access to those sections of the population who tend to access services poorly. Helping people stay well and healthy is a key priority for all working in the new Health Centre and some of these services will also be delivered\provided in other parts of the City.

Paul Bates, Chief Executive of Worcestershire PCT said: “This is a very exciting development which is part of our overall strategy to improve the public’s access to primary care services. Our other major initiative is to encourage GP practices to provide extended hours and many local practices are now submitting proposals to do so.

“We will be working very closely with Elgar Healthcare to make sure that our first GP-led Health Centre is a major success and responds properly to the public’s wishes for more convenient services, including the ability to drop in without an appointment.”

Dr Adam Thompson, Director of Elgar Healthcare Limited said: ” My co-director, Dr Charlie Harris, and I are delighted that the PCT has given us the opportunity to work with them to deliver this new service for Worcestershire.

“Our company is founded from South Worcestershire GPs all keen to build upon the high quality General Practice already delivered in Worcestershire, who see this as an exciting new way to complement existing services.

“We aim to work closely with the PCT to utilise this centre to help improve the health outcomes of those in our community who access health services poorly, to assist in delivering healthcare to an expanding University population, while at the same time improving access for all of our population to General Practice services”.

Ends

For further information contact Rebecca Bourne, Communications Manager, on 01905

760020 or (07775) 816420

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The provider-commissioner split: Getting it right

Posted on April 24, 2009. Filed under: News stories, Reports/papers | Tags: , |

Health Services Journal | BY INGRID TORJESEN | 23 April 2009

A new King’s Fund report warns the chance to improve services could be missed if PCTs do not prepare for shedding their provider role. Ingrid Torjesen explains

Primary care trusts have until the start of November to hive off their provider functions. This will enable them to focus on commissioning by removing the conflict of being both a provider and commissioner, and thereby encouraging competition and improving community services. Or so the rationale goes.

However, history has taught us that new organisational structures alone do not deliver benefits and may cause new problems if cultural and workforce issues are not addressed

Lessons from mental health

In 1990, the care Programme approach introduced a framework for caring for people with mental health needs in the community. It consisted of a systematic assessment of health and social care needs, the drafting of a care plan and the appointment of a care co-ordinator to monitor and review that care.

Experience tells us that a team needs an elevating goal and a set of core values. These fundamental ingredients were frequently overlooked in community mental health teams, resulting in staff burn-out and low morale. Failure to identify what type of patient should be the focus of attention frequently left teams struggling to cope as they tried to encompass everyone referred to specialist mental health services. They now focus on those who have a wide range of needs from a number of services, and/or are most at risk.

A King’s Fund report, Shaping PCT Provider Services,outlines how PCTs should grab this opportunity to take a comprehensive strategic overview of community services required.

Candace Imison, deputy director of policy at the King’s Fund and author of the report, says it is essential PCTs clearly define the role they envision for community services, their priority areas for expansion and any important partnerships they want, such as joint health and social care teams for older people.

There is also a consensus that greater links with GPs would improve services and the appropriateness of GP referrals to them. Although this has been difficult to achieve in the past, practice based commissioning consortiums now provide a structure to which community services could link. “PCTs need to be signalling quite strongly that they would encourage that,” Ms Imison says.

Service demand

While overall demand for community services is growing, the pattern of demand varies between PCTs. Ms Imison says: “It is a real opportunity to be clear about the rate at which those demands are likely to increase and where they will be most focused – the very elderly, or particular pockets of chronic disease, such as renal disease.”

PCTs should also examine services individually to identify which sit naturally together, for example, children’s services may benefit from being strongly aligned to children’s centres.

“PCTs have a historical legacy of services rather than a set of services that have a strategic coherence to them,” Ms Imison explains. “The thing is to really focus on the big building blocks going forward. Providers desperately need that strategic context before they can start planning sensibly.”

Once that context has been determined providers will be able to determine which type of structure would suit them best, such as a social enterprise, private sector partnership, or community foundation trust. However, a new structure will not bring about change without new ways of working.

“It will not just be a question of putting teams in place; if they create new teams they need to work hard with them to be clear about exactly who the services are for, what the referral criteria are and what are the referral routes,” Ms Imison says.

The care programme approach in mental health is a good example of a change that did not deliver what was hoped for, because there was such focus on the mechanism and staff did not understand what it was designed to deliver (see box).

“One of the reasons why some community services aren’t able to offer a proper alternative to hospitals is because they are not operating 24 hours a day,” Ms Imison explains.

PCTs need to do a workforce plan taking account of their strategic needs. If they plan to provide more care at home, this should cover issues such as how community services can attract people who have historically worked in hospitals and are used to a 24-hour culture. It should also prepare for retirement bulges. “It is important people understand what the workforce pressures are and for them to make training and workforce plans that fill the gaps,” she says.

Facilities management

The Department of Health believes PCTs should hold on to community services’ premises because it will give them more flexibility as commissioners, but Ms Imison questions whether this is the best approach.

She says PCTs do not have skills and capacities as estate managers and, as estate is a fundamental part of service provision, holding on to it might create more problems for PCTs than it solves. “While you will get the benefit of the strategic flexibility – if someone isn’t delivering a service you are not tied into them because you have the estate – there is also an issue around the providers; if they don’t own the estate then their capacity to develop and move on their service is handicapped.” 

She recommends PCTs that decide to hold on to their estate consider working with neighbouring PCTs to share expertise, perhaps linking to work around LIFT.

PCTs are under huge pressures, so there is a risk that they could simply tick the boxes and deliver a new organisational structure and arm’s-length governance without seizing the opportunity to think about the services it should deliver.

“A lot of PCTs inherited this portfolio of services and just let them carry on as they were rather than being strong commissioners of them. There is probably a strong imperative not to challenge the status quo because everyone wants an easier life,” Ms Imison says. “The opportunity of the separation is that it forces PCTs to commission the services rather than just hosting the services.”

Tips for success

  • Focus on process as much as on structure
  • Ensure a widely understood set of values underpin the new ways of working and enablers for effective team working are in place
  • Focus on the patient groups who use these services and get significant input from GPs
  • Clarify referral pathways
  • Provide a service that is needs led rather than demand led
  • Group together services with strategic coherence
  • Ensure the community estate supports the model of care
  • Ensure workforce plans take account of a growing and ageing population, and staff retirement
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Shaping PCT provider services: The future for community health

Posted on April 24, 2009. Filed under: Reports/papers | Tags: , |

King’s Fund | Candace Imison | Published: 23 April 09

Primary care trusts (PCTs) provide a broad and complex range of community-based services. However, the commissioning and management of these services have been a challenge for the NHS and in particular for PCTs. As PCTs provide community health services, there is a potential conflict of interest for their role as commissioners. The government is clear that PCTs need to separate their provider and commissioning functions. This report examines the issues surrounding the placement of community health services, the options proposed for their reorganisation, and the steps that must be taken to deliver the desired transformation in community health services.

For full report click here.

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Atos Healthcare: NHS Walk-in Centres

Posted on April 23, 2009. Filed under: Uncategorized | Tags: , |

Atos Healthcare 

Flexible access to primary care is the key to delivering health services that meet the needs of modern society.

The NHS introduced seven new Walk-in Centres (WiCs) in England, run by independent sector providers. These complement existing primary care services such as GPs and hospital accident and emergency departments. They provide patients with a range of services, without requiring an appointment.

Contracts for two of the WiCs were awarded to Atos Healthcare. The first was opened in Manchester on 17 November 2005, and the Canary Wharf WiC opened on 21 April 2006.

The services offer treatment for a range of conditions such as:

  • Coughs, colds and flu-like symptoms
  • Emergency contraception and advice
  • Hay fever, bites and stings
  • Minor cuts and wounds
  • Muscle and joint injuries
  • Skin complaints – e.g., rashes, sunburn and head lice
  • Stomach ache, indigestion, constipation, vomiting and diarrhoea.

Patients can simply turn up at any time from 7am to 7pm, Monday to Friday. If more convenient, they can also make an appointment.

Treatment and advice is provided in purpose-designed medical centres staffed by dedicated teams of nurse practitioners and doctors.

Continuity of care is important so, with the patient’s consent, details of key aspects of the consultation are sent to their GP.

The performance and quality of the service provided by Atos Healthcare is monitored by the Department of Health and the host Primary Care Trust using reports generated by the centre’s bespoke IT system. The centre operates under a robust clinical governance framework with clear lines of responsibility to Atos Healthcare’s Chief Medical Officer.

The Atos Healthcare run NHS Walk-in Centres in Manchester Piccadilly and Canary Wharf were recently awarded the Grand Prix: Best Operational Project across all sectors at the Public: Private Finance Awards 2007. The awards recognise the improvement in public services that the Walk-In Centres have delivered and the benefits that they have brought to the local community.

According to Andrew Ridley, Director of Primary and Community Care Commissioning, Tower Hamlets PCT, Atos Healthcare demonstrated “a strong focus on collaborative working with local stakeholders”.

To learn more about how we are helping the NHS provide primary care, contact Atos Healthcare.

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One Medicare awarded contract to deliver GP Led Health Centre in Grimsby

Posted on April 23, 2009. Filed under: GP-led health centres | Tags: |

One Medicare News

The centre, which will open on Cleethorpes Road in Grimsby on July 1st this year, will be called the Quayside Open Access Centre and it will offer NHS healthcare services to anyone in the area. It will be open 8.00am to 8.00pm, 7 days a week, 365 days a year and will incorporate a walk-in centre.

Dr Phillip Earnshaw, Medical Director of One Medicare sai: “One Medicare is delighted to be setting up an exciting new service. This will be a flagship centre for One Medicare and will provide some welcome regeneration to the Freeman Street area of the town whilst also being available for everyone in North East Lincolnshire to use. We are committed to responding to the healthcare needs of the communities we serve, and look forward to working with North East Lincolnshire Care Trust Plus to deliver an excellent range of services.”

Jane Lewington, Chief Executive at the CTP added, “The confirmation of the new health centre forms part of the Government’s commitment to offer more choice to patients. The awarding of the new contract to One Medicare represents the culmination of a rigorous and exhaustive process to develop a new service which compliments and supports existing local services. The centre will work in particular with the local Open Door service to support the provision of primary care services to patients unable to access care through the traditional service routes.”

The centre  which will complement existing GP services in the area is being designed to take account of local needs and conditions and will provide a range of healthcare services. Residents of North East Lincolnshire can choose to register with the practice if they wish to, or access the services whilst remaining registered with their current GP surgery. For the first time patients who are not registered at the Quayside Open Access Centre but wish to be seen there by a doctor or a nurse can also book an appointment in advance.

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