Typically there doesn't seem to be anywhere to comment - or even scream!
His practice was generously over funded even before he became a fund
holder: I have the impression that they have no problem with premises -
and as he is now said to be a one day a week part timer, I am not sure
how much he realises of the effects of becoming involved with PBC and
other management initiatives and the constant struggle to upgrade
premises when the financial risk falls on practices if schemes fail
because of sudden capricious changes in funding mechanisms for practice
premises funding: and the effect of this on the ability - let alone the
willingness - of practices to deliver on his - or the DH's - agendas for
shifting care, whether funded or not, from secondary into primary care?
This is as much a capacity issue as a financial one: however much you
pay me, there are still only 24 hours in the day!
From a personal point of view, we have a flourishing PBC consortium :
PBC is giving my locality the tools to try to do the things we started
trying to do - as a locality - with a locality commissioning pilot in
1998 (killed off by the introduction of PCGs.. ;-<<<)
*However* the amount of additional work is not trivial and involves both
partners (with loss of time for patients) and practice managers and
staff.
In addition, all the practices in Dunstable have limited ability to
expand services due to lack of space. We have been trying - jointly - to
get a super surgery housing the majority of the practices in central
Dunstable since , IIRC, the times of the locality commissioning pilot -
and certainly since the brief episode of PCGs. Every time we get close,
the rules change: the structure of the PCT changes: the guillotine is
brought down on any plans that had not been started x months prior to
the announcement: the new PCTs are short of cash - and if they are not,
the SHA - sorry, East of England NHS - is.
*How do you expand services when there is no space even to sit down?*
There may be spare capacity in the Primary Care Tsar's practice: this is
not necessarily the case in less fortunate practices.
But then, I don't recall that Tsars had a good reputation for
appreciating the problems faced by peasants.
MaryH
In message <[log in to unmask]>, Robert
Treharne Jones <[log in to unmask]> writes
>I'm sure the group would wish to be given the chance to comment:
>
>GP czar Dr David Colin-Thome has made a clinical case for widening the role
>of GPs to include roles traditionally found in hospitals.
>http://www.dh.gov.uk/assetRoot/04/14/26/50/04142650.pdf
>
>Robert
>
--
Mary Hawking
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