HAH. Telling the PCT to get stuffed is part of the basic PM job description IMHO<br><br><div class="gmail_quote">On 30 November 2011 13:29, Paul Bromley <span dir="ltr">&lt;<a href="mailto:[log in to unmask]"><a href="/cgi-bin/wa-jisc.exe?LOGON=A3%3Dind1112%26L%3DGP-UK%26E%3Dquoted-printable%26P%3D6435%26B%3D--20cf305b13e601adcc04b30246ee%26T%3Dtext%252Fhtml%3B%2520charset%3DISO-8859-1%26pending%3D" target="_parent" >[log in to unmask]</a></a>&gt;</span> wrote:<br>

<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex;">To update my update - LMC reply has been to tell PCT to get stuffed as it is their responsibility to sort out this service if we do not wish to do it. Thanks to all who replied and said the same as LMC - I ahd told my PM this who disbelieved we could tell the PCT to get lost.<div>


<br></div><div>Thanks</div><span class="HOEnZb"><font color="#888888"><div><br></div></font></span><div><span class="HOEnZb"><font color="#888888">Paul</font></span><div><div class="h5"><br><br><div class="gmail_quote">On 30 November 2011 13:00, Paul Bromley <span dir="ltr">&lt;<a href="mailto:[log in to unmask]" target="_blank"><a href="/cgi-bin/wa-jisc.exe?LOGON=A3%3Dind1112%26L%3DGP-UK%26E%3Dquoted-printable%26P%3D6435%26B%3D--20cf305b13e601adcc04b30246ee%26T%3Dtext%252Fhtml%3B%2520charset%3DISO-8859-1%26pending%3D" target="_parent" >[log in to unmask]</a></a>&gt;</span> wrote:<br>


<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">I do not fully understand the politics etc of what I am about to say as I have taken a staying low on all of this locally. It seems that to provide this service at the moment we have to set ourselves up as a provider with numerous hoops to jump through financially/admin etc. We are not providers and do not want to be. The crazy situation that my PM tells me we are being &#39;compelled&#39; to do is to let another contractor take on this work who then has to contract it to us. No doubt they would take a cut anyway and we would have even less. That aside we do not want the work as we believe the amount we get will not cover the aggro. If I heard this from another organisation then I would think it madness!<div>



<br></div><div>I get very annoyed when someone tells me that I MUST do something and want to know why, which I am asking locally. With your responses so far I will tell them to take a long run and jump.<div><br></div><div>



Thanks</div><div><br></div><div><font color="#888888">Paul Bromley</font><div><div></div><div><br><br><div class="gmail_quote">On 30 November 2011 12:12, Saul Galloway <span dir="ltr">&lt;<a href="mailto:[log in to unmask]" target="_blank"><a href="/cgi-bin/wa-jisc.exe?LOGON=A3%3Dind1112%26L%3DGP-UK%26E%3Dquoted-printable%26P%3D6435%26B%3D--20cf305b13e601adcc04b30246ee%26T%3Dtext%252Fhtml%3B%2520charset%3DISO-8859-1%26pending%3D" target="_parent" >[log in to unmask]</a></a>&gt;</span> wrote:<br>


<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<p>One tactic we have previously used is to quote the pct your very reasonable price and ask if they would like you to provide that service at that price for your patients. That way it is clear it is them declining to commission rather than you declining to provide. If they decline to commission you to do it the follow up question is where / how your patients should access the alternative  service the pct has commissioned</p>



<div><div></div><div>

<div class="gmail_quote">On Nov 30, 2011 9:46 AM, &quot;Batchelor, Paul&quot; &lt;<a href="mailto:[log in to unmask]" target="_blank"><a href="/cgi-bin/wa-jisc.exe?LOGON=A3%3Dind1112%26L%3DGP-UK%26E%3Dquoted-printable%26P%3D6435%26B%3D--20cf305b13e601adcc04b30246ee%26T%3Dtext%252Fhtml%3B%2520charset%3DISO-8859-1%26pending%3D" target="_parent" >[log in to unmask]</a></a>&gt; wrote:<br type="attribution"><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">








<div bgcolor="#FFFFFF">
<div>Dear All,</div>
<div><br>
</div>
<div>Absolutely as Russel suggests. It is an enhanced service which is provided at the discretion of the contract holder. If the contractor wishes to sign a contract to provide it do be it but a PCT cannot force anyone to undertake an obligation they have signed
 up to. While there may be downsides the upside is that it protects the public from the worst excesses of politicians and their latest hair brained scheme.</div>
<div><br>
</div>
<div>Paul</div>
<div><br>
</div>
<div><br>
<br>
On 30 Nov 2011, at 09:21, &quot;Russell Brown&quot; &lt;<a href="mailto:[log in to unmask]" target="_blank"><a href="/cgi-bin/wa-jisc.exe?LOGON=A3%3Dind1112%26L%3DGP-UK%26E%3Dquoted-printable%26P%3D6435%26B%3D--20cf305b13e601adcc04b30246ee%26T%3Dtext%252Fhtml%3B%2520charset%3DISO-8859-1%26pending%3D" target="_parent" >[log in to unmask]</a></a>&gt; wrote:<br>
<br>
</div>
<div></div>
<blockquote type="cite">
<div>Enhanced services are voluntary.  Full stop.
<div><br>
</div>
<div>If the PCT are being particularly argumentative, I would refer them to your LMC, who will probably suggest a renegotiation in fee structure for the service.</div>
<div><br>
</div>
<div>In the end, it is a business decision for you.  Your reasoning, as posted, sounds to me to be sensible.</div>
<div><br>
</div>
<div>Locally, we are now the only practice who are not doing leg ulcer clinics.  As it happens, we would prefer to, but our particular set-up is making it impossible for us to take on the responsibility for it (under a LES) in a consistent and robust fashion,
  So we haven&#39;t.  The PCT were rather nonplussed and keep trying to persuade us, but it is impossible as we are too small to take on the extra staff needed given the current level of funding.</div>
<div><br>
</div>
<div>So assuming you are happy with your decision, stick to your guns. Their responsibility, not yours.</div>
<div><br>
</div>
<div>Regards</div>
<div><br>
</div>
<div>Russell<br clear="all">
<br>
----------------------------------------------------------<br>
Manor Park Medical Centre<br>
<a href="http://www.manorparksurgery.com" target="_blank">www.manorparksurgery.com</a><br>
Tel 01323482301<br>
East Sussex Local Medical Committee (Chair)<br>
<a href="http://www.sslmcs.co.uk/" target="_blank">www.sslmcs.co.uk/</a><br>
Tel 01372389270<br>
----------------------------------------------------------<br>
<br>
Have your say about NHS market reforms<br>
<br>
Visit <a href="http://www.lookafterournhs.org.uk" target="_blank">www.lookafterournhs.org.uk</a> <br>
<br>
<br>
<div class="gmail_quote">On 30 November 2011 08:54, Paul Bromley <span dir="ltr">
&lt;<a href="mailto:[log in to unmask]" target="_blank"><a href="/cgi-bin/wa-jisc.exe?LOGON=A3%3Dind1112%26L%3DGP-UK%26E%3Dquoted-printable%26P%3D6435%26B%3D--20cf305b13e601adcc04b30246ee%26T%3Dtext%252Fhtml%3B%2520charset%3DISO-8859-1%26pending%3D" target="_parent" >[log in to unmask]</a></a>&gt;</span> wrote:<br>
<blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div>About a month ago we decided as a practice we would opt out of providing smoking cessation as we did not want to go through the hoops of being a provider, along with the costs of providing the service with the consumables etc. We also decided this on the
 basis of the way that it was funded due to the moving of the goalposts and the fact that for the money coming in it would not be worth the &#39;agro&#39;. Now we are being told that we HAVE TO provide this service as otherwise our patients will be &#39;disadvantaged&#39;.
 The PCT used the same argument with extended house (which we have recently shed). </div>
<div><br>
</div>
<div>I have asked my PM to get them to show us the evidence re why we have to provide this service and why they cannot get someone else to do it for us.</div>
<div><br>
</div>
<div>My question is - can they make us?? <span><font color="#888888"><br clear="all">
</font></span></div>
<span><font color="#888888">
<div><br>
</div>
<div><br>
</div>
-- <br>
Best Wishes<br>
<br>
Paul Bromley<br>
<br>
<a href="http://www.informatiks.com" target="_blank">www.informatiks.com</a><br>
Custom EMIS LV Software.<br>
vuE | GPLabels | GPDocs | eGFRChecker<br>
</font></span></blockquote>
</div>
<br>
</div>
</div>
</blockquote>
</div>

</blockquote></div>
</div></div></blockquote></div><br><br clear="all"><div><br></div>-- <br>Best Wishes<br><br>Paul Bromley<br><br><a href="http://www.informatiks.com" target="_blank">www.informatiks.com</a><br>Custom EMIS LV Software.<br>


vuE | GPLabels | GPDocs | eGFRChecker<br>

</div></div></div></div>
</blockquote></div><br><br clear="all"><div><br></div>-- <br>Best Wishes<br><br>Paul Bromley<br><br><a href="http://www.informatiks.com" target="_blank">www.informatiks.com</a><br>Custom EMIS LV Software.<br>vuE | GPLabels | GPDocs | eGFRChecker<br>



</div></div></div>
</blockquote></div><br>