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against workload dumping is for the CCG to stop purchasing services from the ‘dumper’. That usually stops the behaviour pretty quickly,” says Buckman. “If all the GP members get together and instruct the CCG to purchase elsewhere, then the provider will get the message.”
Practices can demand funding if they can prove that dumping has occurred, but this isn’t always easy. “In practice it is very hard to get money out of a provider who is dumping. CCGs will have to be tougher with them and now is the time to start,” says Buckman. “Only when GPs unite in refusing to do dumped work will it stop happening.” But what do practices do if they want to help? These challenges are often better managed in areas where CCGs proactively engage their practices and audit increasing workloads. The Coastal West Sussex Clinical Commissioning Group, for example, has introduced a number of initiatives to support its member practices to manage and increase effi ciency. These include regular practice visits and peer reviews, as well as a reporting system for practices to fl ag problems and a focus group of health professionals to support best practice in primary care. “At the CCG we take our commitment to our membership practices very seriously,” says head of primary care support and performance, Tina Tomkins. “All of our commissioning decisions start with primary care – and new pathways and commissioning plans keep the role of our member practices at their centre.” Member practice manager Jo Wadey appreciates her CCG’s efforts and believes more commissioning groups need to recognise that practice managers help shape the future of primary care. “We are lucky that in West Sussex they do,” says Wadey, “hence funding and supporting the West Sussex Practice Managers Association and talking to us about how best they can support primary care so that clinical commissioning has a chance [of] working.” And it needs this chance to work: In order for the NHS to relieve itself of impending budgetary doom, services will have to shift to primary care – but without the budget and fi nancial wherewithal to take it on, practice managers are left coping, somewhat altruistically, with stacking workloads that aren’t going anywhere soon. If they are the future of primary care, something’s got to change.
All of our commissioning decisions start with primary care – and new pathways and commissioning plans keep the role of our member practices at their centre
october 2013 23
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