I'd meet with them to discuss it. Only worry is that if you ever change
your mind you will have to get their permission to offer quick access
won't you? Presumably if you offer an emergency only service after a
bank holiday or between Xmas and New Year they could refuse to let you
do this?

In message <[log in to unmask]>, Tim Heywood
<[log in to unmask]> writes
>    Yep - I don't think other local practices would be keen at all. But 
>    by calling their bluff we might force the PCT into creasting a 
>    system purely for dealing with our arsey patients! And at no cost 
>    to us! Surely there must be some cons to balance these pros??
>     
>     
>>       ----- Original Message ----- 
>>       From: Balin Graham (F81606) Harewood CO12 5AD 
>>       To: [log in to unmask] 
>>       Sent: Monday, June 06, 2005 10:40 AM
>>       Subject: Re: Access advice
>
>
>>       Presumably you wouldn?t mind losing a few patients if they felt 
>>       they were getting a ?better? service elsewhere, esp if they are 
>>       the arsey ones. In that case, no problemo.
>
>
>>       However, I would have serious doubts about whether they would be 
>>       seen by anyone else, unless you have local docs with time on 
>>       their hands. I for one, would need a LOT of dosh to see someone 
>>       else?s arsey patients!
>
>
>>        
>
>
>>       It would be interesting to call their bluff. [and Midge?s tape 
>>       recorder idea to use for all meetings on the subject]
>
>
>>        
>
>
>>       :
>
>
>>       Cheerio
>
>
>>        
>
>
>>       Graham
>
>
>>       From: Tim Heywood [mailto:[log in to unmask]] 
>>       Sent: 06 June 2005 10:21
>>       To: [log in to unmask]
>>       Subject: Access advice
>
>
>>        
>
>
>>       Looking for advice on access. It's a complex story, so bear with 
>>       me.
>
>
>>        
>
>
>>       The PCT have been offering Access as an enhanced service under 
>>       GMS2. The spirit of the SLA is what you'd expect - access to a 
>>       PHCT member within 24 hours and a GP within 48 hours. This would 
>>       be tested by a monthly phone call (on a date we knew) asking 
>>       when the next appointment was for a nurse, a doctor etc. In 
>>       common with all the local practices (and I guess many 
>>       nationally) we realised that true access of this nature would be 
>>       a great upheaveal, especially given local issues which are not 
>>       really relevant to my question. Therefore we changed our 
>>       appointment system to let us pass the test without actually 
>>       changing our access. Mea culpa. We have always and will always 
>>       see people on the basis of clinical need as soon as necessary.
>
>
>>        
>
>
>>       Started to feel quite uneasy about this, so discussed it with 
>>       partners. Agree not to sign up to Access this year, take the 
>>       financial hit, but rest on a bed of laurels up there on the 
>>       moral high ground. 
>
>
>>        
>
>
>>       The initial reaction from the PCT was along the lines of, "Well 
>>       everyone else is doing it" and "you really are acheiving what 
>>       the government want" (even after the Paxman interview). They 
>>       essentially encouraged us to continue a practice which we felt 
>>       was close to fraudulent, we assume because they have to tick a 
>>       box for the SHA somewhere.
>
>
>>        
>
>
>>       So now they're trying to get nastier. We had a mail this morning 
>>       from them asking if we understood that they would have to 
>>       commission access for our patients from somewhere, and may be 
>>       forced to offer it to other local practices. There was a sl
>>       ightly threatening feel to this.
>
>
>>        
>
>
>>       Now, it appears to me that what they are offering to do is, for 
>>       a financial hit we have already decided to take, get someone 
>>       else to see some of our patients, probably the most arsey ones 
>>       who aren't willing to wait a week for a problem they've had 10 
>>       years, thus reducing our workload, average "client-arseyness" 
>>       and stress levels.
>
>
>>        
>
>
>>       It seems to good to be true, so what i'm asking is, "Is it?"
>
>
>>        
>
>
>>       T
>
>
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