Collaborative Arrangements

Since 1974 the collaborative arrangements have enabled local authorities to secure primary care medical services essential for the provision of education, social services and public health at no charge to the patient.

Collaborative Services include:

o           reports about children in care or being considered for adoption or fostering

o           reports on prospective adoptive or foster patents

o           psychiatric reports/examinations under the Mental Health Act

o           attendance at case conferences/meetings arranged by Social Services;

o           notification of infectious disease;

o           reports for priority housing for local authorities;

o           certification for chronically disabled or blind persons to obtain telephones.

o           certification for Blue Badge (disabled parking) permits

 

Under locally agreed arrangements, the PCT has in the past been paid the GP a fee that was fixed by the DDRB and published in an NHS circular.   This has now changed because of concerns over the issue of competition.

 The DDRB has not recommended fees for 2006/07 and has advised doctors to set their own fees for this work.

 Individual doctors may now choose to withdraw from existing arrangements based on the 2005/6 fees by giving their PCT 3 months notice, after which new practice fees can apply.

(GPs with specific contractual obligations, eg PCT employees may need legal advice.)

GPs are often the only individuals that can provide these services and the rate of pay may on occasion be of secondary importance, especially in cases where ethical considerations or maintaining the doctor-patient relationship impose particular professional obligations, especially in relation to children.

New fee levels must be individually determined and should be reasonable, transparent and subject to scrutiny and preferably notified to the PCT in writing for their agreement. 

Fee setting & competition legislation

Competition legislation and the Office of Fair Trading (OFT) prohibit the BMA, LMCs, LNCs etc from advising on fees.
 

It is illegal for individual doctors or staff to discuss their fees outside their practice. 
 

Penalties for breaching this law are severe and can be up to 10% of organisation/practice turnover (not profit).

Wessex LMCS is, therefore, unable to provide specific advice to practices on fee levels.

Further advice from the BMA is expected.

CED     May 2006