Experienced Healthcare Chief Executive, having built GP Care UK Limited from a 'start-up' into a successful clinician-led provider of community based healthcare services to NHS patients. Over a period of 6.5 years in the role the business has consistently delivered at least double digit growth and now has a high quality senior management team and over 50 staff plus a large network of subcontract clinical service providers including a number of NHS hospital trusts.
In Q1 of 2014 the organisation was awarded 5 new AQP contracts and was successful in its £5m application to the PM Challenge Fund to support the development of 24*7 integrated primary care services.
Looks pretty clear that the public don't really understand what is going on which is a problem in itself - Dr Nagpaul is clearly on the case and I am sure we all wish him all the best.
Once informed I would encourage the public to consider the risks on both sides of the argument about anonymised (statistical?) data sharing before concluding on a view....
On one side...the risk that we as a nation fail to prevent death or disease, or are at least impeded in doing so, on account of lack of information.
On the other side...the risk that information governance infrastructures fail and data confidentiality is breached in some way and that individuals are embarrassed, inconvenienced or even harmed.
However the real issue for us as patients is "why are the A&E, Out of Hours and ambulance teams still not able to access [FULL and NON ANONYMISED] records that would be helpful (or possibly critical) if they were unconscious and in a life threatening condition"? Most members of the public mistakenly assume that they can.
On either argument should the sensitivities of the vocal few deny benefits for the masses? Giving an Opt Out caters for both and is a pragmatic solution; whereas Opt Ins are hugely expensive for the tax payer (circa £65m for each Opt In if you assume £1 per letter/envelope/postage - ignoring the many other costs of administering such a process).
GPs are certainly best placed to provide LES/DES services; they have the clinical expertise and a delivery network that cannot be matched in delivering care closer to home; and it is a nonsense that Commissioners find themselves in a position where they have to disrupt something that is already in place and generally working well - at a time when there are so many other pressing priorities.
However, if AQP is going to happen then primary care needs to prepare. Things that need consideration:
- The AQP submission: Assume this is some 20 pages of A4 text, covering a variety of questions but which will likely include: Experience; Care pathway; Follow Up Care; Working with Local and Social Services; Subcontractor Relationships; Clinical Governance Processes, including Governance Framework, Clinical Incident Reporting, Dealing with Immediate Critical Incidents, DBS/CRB checks; Proposed Innovation beyond the specification; Workforce Continuous Development; Compliance with Public Sector Equality Duty; IT Architecture including Information Govenance Arrangements; Clinic Locations; Access Plan re Working People and the Disabled; Mobilisation Plan. The last one we did had a max word count of 500 words on most of the above items (and you would be well advised to use up the word limit - one line answers rarely show you at your best). Yes, if you have done one before the there are efficiencies in preparing a PQQ submission a second time around - but how many practices are currently in this position?
- Are you ready for a 100+ page NHS contract? Whilst there is little room to negotiate any variation, anyone signing up to it should still read it and understand it properly
- Will the CCGs really want a contract with each and every practice (100+ pages for each ??) or will they prefer one 'consolidated' provider who can provide the pan-CCG solution; if the answer is one consolidated provider then what primary care organisation is going to hold the contract? Does that legal entity already exist? Is it CQC registered?
- Who is going to undertake the ongoing contract management duties such as performance monitoring, reporting etc
My advice......practices should start working together now so that they are in a position of strength if / when they have to tender against some of the big private providers who arent so focused on local engagement and integration and who have dedicated teams who can crank out AQP submissions by the bucket load.
There are a number of organisations being created by groupings of GP practices which is encouraging - however this process needs to accelerate if primary care is to be ready for LES/DES AQPs from April 2014. Watch this space for an Association of GP Provider Organisations - coming soon !