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Innovation on ice

Suffering from writer's block this month, our diarist looks for inspiration from his editor and feels a chill settling in.

The story so far

Dr Peter Weaving is a GP and locality lead for Cumbria PCT. As a former chair of a large consortium he can see many sides of the exciting business plan he's been given – particularly now the financial climate has become much colder...

I'm sitting here in this freezing garret like a blinkin' student with a fleecy dressing gown on and an electric fan heater trying to melt the frost on my heels. I can't go to bed until I've finished this article because Sue, my editor, has given me a deadline of tomorrow.

I went skiing with the children the week before Christmas, though there was more snow at home. My return seemed to coincide with a festive malaise gripping PCT and practice alike. The NHS, apart from fracture clinics, appeared to have ground to a halt on my return. How can I write about what's happening in PBC when I feel I haven't been at work, written a prescription, looked at a business case or referred a patient for months?

In desperate search of inspiration, I wonder what Sue has been up to. It's not often I read what my editor writes (usually ‘Try harder' or ‘Could do better') but I was fascinated by her ‘I wish he'd said this' piece on the Practical Commissioning website ( The basic premise is that GPs should provide everything they want to if they're up to the job of doing so.

Now that reminds me; I have seen a business case and here it is. A modest little development of practices needing projected rent reimbursement of £1m a year from the PCT and a request for a clinical chemist to run the on-site near-patient pathology service, to be housed in the diagnostics wing between the MRI and CT scanners.

Well then, Sue, it looks as though we have a challenger for your gauntlet. Nine consulting rooms for visiting specialists and their teams – you go guys! We have everything here from health and social care rooms and ambulatory care suites to male recovery and an electronic games room. We have optometry, pharmacy and security, not to mention a Costa Coffee and two gyms. This is a health city not a health centre. Meet the future – I'm proud of the guys who've written this plan!

These docs provide good primary care out of terraced houses at the moment, but when asked to plan their future they've side-stepped the Henry Ford adage ‘Don't ask the people what they want, they'll say faster horses' and have roared into the next generation of primary care. These guys are going to do everything for their patients and if they can't do it themselves they'll bring in someone who can.

A flurry of snow rattles the window and brings me back to reality – in a world of negative growth, how do you fund the dream? The position I'm in as the locality lead is to say: ‘Sorry, guys, no high-powered diagnostics, too expensive and apply a thousand other cuts to make the project affordable.'

Do you know what I really want to do?

I want to take Sue's premise to the nth degree and say: ‘Okay, guys, here's your share of Cumbria's £800m – now show me what you can achieve.'