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With the new contract well under way, Dr Bob Button advises practices on what they need to be doing in July


Now you have reached the end of the first quarter it is time to assess the financial health of the practice. The first instalment of income tax is due and the PCO should have finalised your budget. You should now have a better idea of the money coming into your practice as well as the deductions being made for superannuation. Do not forget that your access and QUIP payment was at an annual rate in April and will not repeat.

The PCO should now have made plain its intentions on taking over full responsibility for out-of-hours. Most are taking over on October 1. The practice must make sure it has given the three months' notice of intention to opt out and has cancelled any arrangements involving commercial deputising services. Practices will be approached regarding GPs working in the PCOs' new rota arrangements. GPs should co-operate in this almost regardless of remuneration. The important thing is for the PCO to take over responsibility.


Travel is in everyone's mind around now and the practice will no doubt be approached about travel vaccinations. Many practices have a nurse-led system and there must be complete clarity about the fee structures. Remember that GPs are required under essential services to give advice to patients about travel requirements without charge, but are fully entitled to claim a fee for vaccinations that were not given free under the old Red Book arrangements.


Enhanced services should now be clearly agreed between the PCO and practice. In particular the arrangements for minor surgery should be reviewed to ensure practices are not overperforming to such an extent that they will overspend their budget. Should this be likely it would only be fair to let the PCO know since it might wish to increase the budgetary allocation.


The practice should have decided whether to implement the proposal in the NHS Plan that all letters concerning patients should be copied to them. Practices cannot be forced to do this. In some ways it is a good idea, but cost issues have not yet been addressed and practices may prefer to wait until they have been before deciding on their arrangements. GP appraisal arrangements and the associated funding should have been agreed by now with the PCO. Practices should have started appraisal reviews of their staff so that planning can be implemented later in the year for new staff or new responsibilities for existing staff.

Bob Button is chief executive of Wessex LMCs

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