The Lander Medical Practice is based in an NHS LIFT building, which opened in 2010, and is one of two practices that serve Truro and its surrounding area from this building. Both practices have their own in-house physiotherapy services. Lander’s was set up in 1994 under GP fundholding
When Cornwall PCT announced it would be inviting tenders for any qualified providers (AQPs) to provide back and neck services, both practices decided to bid independently to be a provider, to protect that element of our budgets.
If our practice had been unsuccessful, we would have lost 16% (£11,167) of our budget, currently £69,798 per annum, which provides 58.5 hours per week of physiotherapy for our patient list of 15,700.
First steps in the process
Our first step in the process was to register with the Supply2Health website for an AQP account, to receive notifications of AQP bid offers.
We were also able to download the national specifications for the service and a bid offer from another area, which gave us the details we needed to complete the bid for Cornwall when it became available.
We knew that the only main difference would be the local questions. With this information, we were able to start preparing our application.
Information required for the bid
We formed a team consisting of a physiotherapist, a lead GP and myself, the practice manager. The physiotherapist produced four reports, detailing our service experience, the care pathways, follow up care, collaborative working and emergency protocols.
I provided information on our clinical governance processes, clinical incidence reporting, a description of how clinicians would deal with critical incidents, a description of our health and safety procedures, infection control and processes for disposal of clinical and other waste.
With all the descriptions, copies of relevant protocols had also to be provided. I also had to write a report on how the Practice demonstrates compliance with the Public Sector Equality Duty Act.
Our lead GP provided overall support and the relevabt information for the local questions. These related to delivering service for local requirements, mobilisation of the service and interface with existing providers and engagement and integration with the public, primary care, secondary care and voluntary sectors.
Finalising the application
Once we received notification from Supply2Health that there was a request from the Cornwall PCT for bids for the musculoskeletal service, we had two weeks in which to finalise our application and submit it online via the website.
This proved a rather laborious task. It was necessary to exit the website regularly to check that the text had been saved, as the website was unstable. I had also prepared flow charts to described some of our processes, but was unable to transfer these onto the website in their existing format, so they had to be re-written as text documents.
We chose to submit the application on the last day, unwise in hindsight, however our submission was made before the deadline time, much to my relief.
There then followed a period of close scrutiny of our emails, as we knew we might receive questions from the national assessors, which would require a very quick turn around. For example, one was received on Friday evening at 5pm and required an answer by 5pm the following Monday. Some Saturday working was required. Finally all the questions were answered and we were then able to accept referrals to the service.
How the service works
We allocate slots for the service equating to approximately 55 hours per month. Payment is claimed on completed episodes of care at discharge, with the tariff set at £120 for a complete course and £40 for a single assessment where the referral is deemed inappropriate.
Currently we are allowing one hour for a new referral with 30 minutes for a follow up. We have had to increase our administration support specifically to manage the significant data demands of this new service.
Although having obtained separate contracts, we are working collaboratively with our neighbouring practice in the provision of the service to allow a wider scope of appointment availability. We are open to referrals from other GPs in the area, but have started slowly by treating our own patients to ensure that referrals and discharge systems flow correctly.
|Advice for practices tendering for AQP services|
- Liz Wilson is practice Manager at the Lander Medical Practice, Truro, Cornwall