New contract 2006: vanishing predictability
 

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New contract 2006: vanishing predictability

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New contract 2006: vanishing predictability

 

New contract 2006: vanishing predictability

Don’t you just hate it when, every year on 1 July, Mr or Mrs Clever Trousers takes great pleasure in being the first to wish you a ‘Happy Christmas’, as they have spent the entire morning working out that their next six-monthly review appointment – which they book to the day - will be on 1 January.

To make matters worse, as you get older and the policemen do seem to be getting younger, this period of six months does seem to come round quicker and quicker.

When you read this it will be after 1 October; so what are you going to say to Mr or Mrs Clever Trousers now, since their next appointment will be after the April introduction of the new contract. Yes, it is now just one check up interval away and decisions have to be made now. If you are going to follow the NICE guidelines for recall interval, you can really get one over on the Clever Trousers by saying ‘According to the risk assessment I have done today, I hope you have two good Christmas’ in 2005 and 2006, because I will not be seeing you until then!
Speaking to colleagues in the past about the reasons for remaining either completely or partially in the NHS, the most frequent one mentioned is that of predictability – the comfort zone if you like. It was predictable that you would have enough patients, it was predictable that if you worked your fingers to the bone that you would make an income, and if the heart surgery was successful and the rehab from the alcohol and other ‘substances’ was completed, there was a predictable pension to live on. Overnight, all this predictability has vanished.

I have no doubt that the demand for care will always be there, but no matter what anyone says, the financial predictability has gone. Currently our local hospital is some £8million overdrawn.

This budget overspend has led to wards simply being shut, the local cottage hospital which serves a widespread community is threatened with closure, and staff are having to reapply for their jobs. Experienced nurses are being replaced with new, inexperienced staff because they are cheaper. Once the honeymoon period is over the same budget constraints will apply to dentistry.

The frustrating thing for the clinical staff in the hospitals is that they have no control. They have even been blamed for creating the deficit as they have provided too many operations, which they needed to perform in order to meet the targets that had been set. At the same time the ever increasing numbers of managers spend time producing the European paper mountain of memos and initiatives to cover their backsides.
In entering this new contract, practitioners will be loosing a significant degree of independence. Currently a practitioner can set up a practice in any location that they feel will be viable, they can decide on the ‘mix’ of the practice and all management decisions remain within the practice.

In the new world, the PCT will decide on the locations for services, and will impose conditions as to what happens within the practice. The PCT will require you to see Mr Clever Trouser’s far less pleasant neighbours in your reserved emergency slots. It is my opinion that this is just the first step to removing the independent contractor status of dentists within the NHS.

So I would urge any practitioner to be proactive and take a long hard look at their future now, decide just how predictable this new world is going to be, after all its just one check up away.

 Posted on : Fri 14th - Oct - 2005

 

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