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PCT relations: helpful or hostile
3rd Feb 2006
Make an informed choice about the new contract, says Jerry Watson Make an informed choice about the new contract, says Jerry Watson There can be no doubt that one of the most prudent new year resolutions must be to make an informed choice about the level of commitment to the new contract. The contract is available as a downloadable file on www.primarycarecontracting.nhs.uk but beware before you print the file it is 153 pages long! There is nothing fundamentally new in the contract from that which was published last summer for discussion. So despite all the discussions and huge reservations by the profession little has change to make the contract more palatable. There is I think some sound, generic advice to be had. First, have a general look at the contract and notice the very different relationship that as a practice you will be entering in with your PCT. There has already been expressed a huge range of experiences in dealing with the different PCTs. Some practitioners have described a helpful partnership relationship, while others have described the relationship as hostile. Ask yourself, ‘am I happy entering into this contract with my PCT?’ Looking at the general flavour of the contract you will be far more accountable and much closer to home than the previous relationship with the DPB. You will have to provide the PCT with a copy of estimates that include private work and the cost of that work, and according to clause 255.1, you have to send the PCT a list of all gifts that you receive from patients. Specifically all those undeclared tins of Scottish shortbread at Christmas! Assuming that you do wish to enter into a contract, then my next advice is ‘get advice right now, time is running out’. No matter what the contract value is be absolutely sure that you understand what you are letting yourself into. A contract value of a couple of thousand pounds will carry the same responsibilities as one for a couple of hundred thousand pounds. The problem is that this is local commissioning so you need you be sure that you take appropriate advice on the contract that you will be signing. Get a draft proposal from your PCT and then if there are other local practitioners you can maybe club together and get collective advice. Getting the contract set up correctly, particularly in areas like section 26 in which you need to state exactly the groups of patients that you will be covering for care. Also setting up the ‘normal surgery hours’ you may wish to exclude evening surgery times from the contract. You need to be sure that funding has been allocated for clinical audit projects as you may well be due to do one as part of the general regulations, all these small details are far easier to deal with before signing than after. Time is running out. The suck it and see approach will not work. Within four weeks you will need to sign some sort of contract, so take advice now and craft the best deal possible for yourself, or make alternative arrangements: but do it now.
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