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Secret Diary - Preparing for a post-pandemic Primary Care

The pace of change is speeding up...

Following my recent blog on the changes to the rollout of the Covid Vaccine for the under-50s, there have been some interesting developments.

To summarise, the NHS wanted surgeries to sign up to continue the vaccination programme for the under-50s, whilst recommencing all QOF work, and stopping any extra COCID financial support. Our PCN thought long and hard and decided to opt-out of giving the under 50 the jab, for several reasons.

There was a view that having one year without much QOF work would be acceptable, but going a further year was not in the patient’s interests, and that the balance had to be restored in healthcare.

We also had to factor in that without the backfill monies from the previous £150m, to fund it was not viable as well as having to do everything else. We felt that if we continued, we would be losing money and as a commercial decision, it was not viable. 

Before anyone suggests that all we are concerned about is making money, let me say that none of us would provide a service for a loss, and there comes a point when more work cannot be physically taken on.

I understand that these views were echoed up and down the country and like us, most PCNs pulled out.  I do not think that the NHS realised this was going to happen, and our CCG then asked us, what it would take for us to change our minds?

At the same time, NHS England did another U-turn and announced a further £120M Covid backfill fund. So we reconsidered, but we still weren’t convinced we could do all the under-50s vaccines and still recommence QOF. We put together a wish list that recognised all the issues and included things like reduced reporting for the next few months and an easing in QOF at least for 3/6 months and put it to the CCG as requested.

We got a positive response as to say our wish list was the same as many other PCNs and they will get back to us so watch this space. I think we made the right decision as it has now been announced that from September 2021 that a booster Covid Vaccine will be delivered and that will be another thing we will need to factor into our workload.

Nightingale Hospitals

On another issue, I was amazed to see that the NHS was going to give away equipment that had been bought for the Nightingale Hospitals that had now been decommissioned.

The equipment was extensive and expensive and had not been used in most cases, it is as though they are just writing it off for zero.   Are they that convinced that next year these hospitals may not be needed, why not put the equipment into storage? 

I will not deny that we will put in a bid for some but wonder if some of the items have already been earmarked or promised to others. 

Finance Payments

Recently I wrote about the GMS/NHS/COVID payments and complaining that it was impossible in a lot of payments, to reconcile.

I am sure that many of my colleagues around the country were volunteered to handle the PCN finances that must come into a PCN member practice, I was, and it has been a nightmare and continues as such.

PCN payments mixed with GMS payments, no breakdown of monies received, and the clawing back of monies that I had proof of signing off for the number of vaccines given of over £70k, only to be paid back a few days later but for £5K more. Why do I have to continually chase these payments?

I am now at the end of my tether they have now written to me saying that I never submitted receipts for items claimed going back as far as February 2020, and now they want them AND supporting evidence!

I cannot be the only one with such problems, and we should join to campaign for clearer accounting from the CCG and the NHS. As more and more monies will be coming through PCNs the problem is only going to get worse.

Why am I told that they cannot pay, and yet send separate payments to the PCN?  When it comes to primary care, does can’t actually mean won’t?


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