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in interest accordingly. “A simple fact that the accountants are saying is the average GP surgery of 6,000 patient size will probably lose going on for £30,000 this year because of local enhanced schemes being discontinued etc. That’s a huge amount that the practices have to fi nd from somewhere else. Just simply being part of a buying consortium – and it does vary from practice to practice on the size and how they’re buying in the fi rst place – typically we’ve found that we can save anything between £5,000 and £15,000 for the practices.” Masters’ own organisation, for example, has saved as much as £100,000 a year.


This saving is coming from all kinds


of areas, and GP practices grouping together like Caradoc at the very least provide a benchmark to compare prices. Masters gives the example of telephony. “If a practice hasn’t negotiated prices on their telecommunications for 18 months to two years, with prices coming down, they’re probably paying more than they need to,” he says. “I’ve just been into one practice, and literally the savings just on the telecommunication was in the region of £3,000 a year.” Of course Caradoc is just one example


of a trend that’s seeing practices all over the country team up for better prices. Clinical commissioning groups seem to offer the perfect platform for better buying terms, since practices are conglomerating under the CCG umbrella anyway. But Masters urges caution. “There’s a hell of a lot of work involved in setting up a buying consortium,” he says, working out terms for 100-plus suppliers can be time-consuming.


FEDERATING FOR FUNDING Another way of making back that £30,000 is by setting up a GP federation to build kudos for contract tenders. This is something GPs are doing in Masters’s local area of Shropshire, Telford and Cheshire. “The GP federation doesn’t sit alongside the CCG, but it can actually bid for contracts that the CCG puts out,” he explains. “For example, we’ve recently bid for stop-smoking services in Telford and weight management services in Shropshire.” He believes federating is the way to go when it comes to building clout. “A single practice won’t have the resources or the fi nances to actually bid for some of these tenders,” he says. “But there’s nothing to say those services can’t be provided by a cohort of practices across a patch.” It’s practices


26 october 2013


A single practice won’t have the resources or the fi nances to bid for some of these tenders. But there’s nothing to say those services can’t be provided by a cohort of practices across a patch


acting completely on their own that worries Masters. “The stop-smoking tender that we did in Telford probably took us a week and a half to two weeks to do. I don’t think a single practice manager would necessarily have the time to do that, plus one practice on their own, could they deliver a service across the whole area? Probably not.” He believes GP practices working together might just have the strength to stand up against the big corporations – they also might be able to collaborate on specialisms like dermatology or audiology for Any Qualifi ed Provider. “You do need some specialist resource if you’re putting a pathway together,” he advises. It’s also useful to have a single point of access when offering services and, as such, ShropDoc’s back offi ce facilities are used by its local federation. To support these conglomerates of independent practices even further, Caradoc is planning to launch an association of GP federations to help individual groups with tendering. This federation of federations will also be free to practices. “So if a federation in one part of a country has won a contract, there may be a way that they could share that information with another federation around the country to help them win a contract,” says Masters. “With practices losing some of the LESs, it’s a way that we see as helping general practice to put some income back in their books.” Grouping or no grouping, something has


got to give. “GP practices are under threat from everywhere,” says Masters. “If the accounts are right and income is going to be reduced, then effectively that’s only coming out of one place – and that one place is the GP’s salary.” And practices should not be put off from going for lucrative tenders. “GP practices are ideal to deliver those services – they all pass CQC and they’ve got all the infection control and all the other protocols in place to put them in an ideal position to actually start bidding for and winning some of these services, but it does need some coordination.” It’s on this ability and willingness to coordinate, Masters believes, that the future of general practice rests. “It’ll be very diffi cult for small practices to operate and balance the books without doing something different. The model’s changing and with all these government pressures on reducing public costs, you have to change the way things are done.” It seems change is on the cards, it’s just a question of how your practice plans to adapt to it.


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