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How to...Set up a minor surgery service

PCTs across the country are either putting out to new tender or else renegotiating the minor surgery offering in primary care as part of cost-cutting measures for 2007/8. How can surgeries respond to this challenge without extending their resources or suffering financially? You should:

PCTs across the country are either putting out to new tender or else renegotiating the minor surgery offering in primary care as part of cost-cutting measures for 2007/8. How can surgeries respond to this challenge without extending their resources or suffering financially? You should:

1. Decide as a partnership whether you wish to get involved. If so, is it to offer a better service to your patients or as a buffer against budgetary pressures or in order to increase practice in

  • come?

2.Research the market. If you have performed the service before, what were the pros and cons? Where did problems arise? How much did it cost in both time and labour? Try to find out how other service providers fared.

3 Establish whether you have genuine surgical skills within the practice. Do you have doctors with more than the basic surgical or anaesthetic training?

4 Set up a project team that includes doctor, nurse and administrator.

5 Define clearly what procedures are to be included. Is this to be purely lumps and bumps or a higher level of service such as vasectomy, hernia or varicose veins? Will you be including curettage and cryotherapy?

6 Decide whether you have the physical facilities for the service. Do you have an adequate room, couch and equipment?

7 Estimate your costs for each procedure. Remember to include items such as local anaesthetics and dressings.

8 Write a tendering document that includes all the above points for submission to the PCT.

9 Set up a face-to-face meeting with the PCT to discuss your tender. Be prepared to discuss historic costs and estimates on the ongoing savings vis-a-vis a hospital-based service or that provided by a private supplier.

To sum up, be prepared, with facts and figure to hand, for some hardball negotiating with the PCT in order to continue providing a service for your patients without incurring financial loss to yourselves.

Dr Jim Sherifi is a GP in Sudbury, Suffolk

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