Developing a Provider Organisation Mark Jones 17 November 2006

Opportunity Providing is the financial opportunity not commissioning The government still wants to move activity out of the hospitals and into Primary Care West Herts PCT supports this agenda? Withdrawal of services at Hemel Hospital may create a big opportunity The PCT wants to deal with a single GP provider organisation? Should DacCom be the vehicle for this? 17 November 2006 Mark Jones

Contracts We may be able to secure a position as a preferred provider And avoid the need for competitive tenders The DoH is progressively reducing requirements for tender And there is no requirement if the provider organisation owns a patient list 17 November 2006 Mark Jones

Conflicts of interests There is a theoretical conflict if GPs have both commissioning and provider roles Others take a robust view The PCT has both roles Commissioning organisations elsewhere have taken on a provider role? If necessary, DacCom could devolve its commissioning role 17 November 2006 Mark Jones

SWOT analysis Opportunities Threats Strengths Weaknesses Ensure high quality services Hold a position of influence Grow practice profit We always thought providing was the worthwhile part of PbC Threats Commercial competitors get there first and eventually break our monopoly of GP services Commitment from the PCT is uncertain Strengths We own the patient list and are the gatekeeper for referrals Clinical expertise Facilities and support staff Relationship with secondary care Credibility Weaknesses Little commercial experience Lack of resources Not sufficiently agile to respond to rapidly developing opportunities Aversion to financial risk 17 November 2006 Mark Jones

Business structure Ensure a fair return for all participants Resource providers Administrators Referring practices Avoid competitive tenders if possible Ensure conflicts of interest are addressed Address our areas of weakness Secure buy-in from the PCT Identify and address any need for capital investment Take account of other stakeholders / players Hospital trust Commercial providers Neighbouring clusters 17 November 2006 Mark Jones

What are we asking for today? Agreement in principle that DacCom should seriously consider developing a provider function Identification of major issues and red lines 17 November 2006 Mark Jones

What will we do next? Develop an outline business model Open discussions with the PCT regarding a provider role Seek approval from the Practices before proceeding further 17 November 2006 Mark Jones