I was really struck when we were recording this month’s episode of the Practice Manager Panel podcast of just how positive an experience the vaccination programme has been so far for general practice. What is important is that the money flows to practices do not make it all turn sour.
The vaccination programme really has been a great achievement by general practice. Not only that, but patients and the public at large recognise the tremendous contribution GP practices have made, and how important this has been in enabling the country to get on the road to recovery. It is not always the case that such a contribution is recognised, so practices should definitely enjoy it while they can!
Not only has the programme been a success in getting patients vaccinated, but it has also helped joint working between practices. Many PCNs who were ambling along without much sense of purpose or any real joint working between practices have found the focus of the vaccination programme has strengthened relationships and created a sense of tangible collective achievement. Nothing builds trust as much as doing something together!
What is important now is that PCN groupings get the money flows right. Nothing makes or breaks relationships as much as money.
It is not going to be an easy task. The first challenge is there still exists some reasonably significant discrepancies between the activity undertaken and the payment schedules on the MYS system. If PCN groupings do not receive the money they are expecting, how is that shortfall going to be shared out between the individual practices? Who is going to make that decision?
The second challenge is this is a significant amount of money that is going to be paid to the lead practice identified when practices signed up to the enhanced service. Some areas will have been more robust than others in agreeing how costs incurred (which may well have been higher than originally anticipated) are calculated, and therefore what the payment to individual practices within the PCN grouping are to be.
It is not difficult to envisage a scenario where either the lead practice feels hard done by, or the other practices in the grouping feel hard done by, because of perceptions of unfairness in how the received funding is then allocated between the practices to cover costs.
Now, as one of the practice managers on our panel discussion rightly pointed out, “the vaccination programme is far bigger than just getting paid”. But she went on to say that at the end of the day all of those practices still have payrolls to meet and bills to pay. If the programme ends up leaving some practices out of pocket, especially when there is a sense of unfair treatment alongside it, much of the good work achieved to date could end up being unwound.
Let’s hope these fears amount to nothing, that the funding received at site level does match the activity undertaken, and that sorting out the funding between the practices within the PCN grouping does not raise any major issues. However, if I was running a practice right now, I would be working hard with my fellow practices to give this process every chance of running smoothly once the money does finally arrive.
Listen to the practice manager panel discussing these issues in episode seven of The Practice Index Podcast here: