Minutes of meeting re Urgent Care at PCT, Watford
Friday 6 October 2006 13.30

Present : Dr J Cohen, Lynn Dalton, Dee Boardman, Jackie, Toni Legatt

Funding in general discussed. At present wait for USS long >15/52 and cannot get BNP test unless refer via OPD at cost of ~£150. From April 2007, USS will be done within 20 days and BNP tests should be available within 2 days via private providers. Discussion re implementing BNP testing locally earlier to help with QOF targets – should reduce need for cardiology referrals and ECHO’s thereby reducing costs. Next April will also see renegotiation of SLA’s, reducing work to the WHH Trust and increasing work to Primary Care with appropriate funding (we hope). 

Of note, Urgent Care in Bedfordshire was contracted as an APMS contract and there is no reason to suppose that that will not be the case here and indeed it is likely to happen. It is a directorial decision. We will need to do a feasibility study and we should apparently not be downhearted as it is thought that Primary Care is “less likely to overstate our abilities” when compared to an APMS contractor! However Luton PCT lost the bid to provide the service. Watch out!

Tariffs for MIU may be reduced to £38 from current £54 (?why). This may make it harder to produce savings unless we work outside tariff. 

Other factors to consider include TUPE (transfer under protected employment rights) and GAD (Government Actuaries Department Certificate). Staff that need to be “TUPE’d” have to ensure new employer has a GAD. This will be dependant on who runs the Urgent Care Service.

I presented the Urgent Care Service idea which was well received. However I think that a triage Doctor will have to be an integral part of the proposal rather than “in-house GP triage” as otherwise, according to the PCT, we are not really making any headway and are continuing what we are doing which “does not appear to be working”. Other interesting developments include positive reception of my idea of wireless access and a laptop in every practice to allow remote working from any part of the surgery when triaging. Also mentioned idea of recording ALL telephone contacts with the service (should we all be doing this anyway?). Targets were discussed and I pointed out that targets increase pressure which does not always result in appropriate medical care and may end up costing more just to ensure target is met. Dee asked for a copy of my presentation and understands it is in DRAFT format at present.

Actions Agreed
•	JC to contact Pam Lumsden re IT and viewing TPP system (01923 830056 / 07775 758503) – appt made Tuesday 17 October 2006 at 13.00 at Milton House Surgery

•	PCT to cost out MIU option as per MIU at SACH

Next Meeting : Friday 20 October 2006 at 13.00 at PCT, Watford. 

Jeremy Cohen
9.10.2006