The development of effective and high-quality primary care services, including enhanced services , is one of the keystones of demand management and delivery of the out - of - hospital care agenda.
We have developed our own form of (PMS) and (SPMS) contracts as well as a variety of (APMS) contracts as precedents for various situations, which we make available to clients. An example of our recent work in PMS is advising a Primary Care Trust (PCT) on terminating its existing PMS contracts and introducing a new contract which delivers better overall value for money. We have advised, or are currently advising on, a large number of APMS procurements in a wide variety of areas including prison health services, urgent care and new health centres. We are also advising on nearly 90 procurements of new health centres/GP surgeries under the Equitable Access to Primary Care scheme.
We have provided extensive training in relation to the implementation of the (GMS) and (GDS) contracts and have regularly advised on its interpretation and ongoing management including variations required by new Directions; standard form remedial notices; and termination as an alternative to pursuing a removal of the performer. We have particular expertise in this area, being legal advisors to the Appeal Unit (NHSAU) arm of the NHSLA, which manages contractor disputes. Our expertise in this area enables us regularly to prevent contract disputes reaching the Appeal Unit oral hearing stage. Our advice to the NHSAU also includes advice on pharmaceutical appeals, in particular when their own decisions are being judicially reviewed.
We have a thorough working knowledge of the new arrangements for Essential Small Pharmacy Local Pharmaceutical Services (ESPLPS) schemes. We were recently instructed to develop and draft a model ESPLPS agreement in compliance with the new legislation.
Performance management
It is often the case that the people managing contracts are not those who have been involved in their development and without appropriate briefing, the full benefits of the mechanisms in the contract may not be properly realised. On completion of contracts, we can prepare for you or support you in the development of “user” manuals in order to ensure that the contracts are used effectively.
Our commercial team regularly advises clients on the interpretation of contracts and tactics where particular issues arise. In the case of disputes, our commercial disputes team provides expert support. They are highly experienced in all forms of Alternative Dispute Resolution including mediations, arbitrations and Early Neutral Evaluations. They are also adept in advocacy which gives us an advantage in urgent injunctive work. Our commercial disputes team is also skilled in handling complex fraud cases.
Primary Care Regulation
We advise on all areas of primary care regulation, including the contractual relationship between independent contractors and PCT funding issues, powers, disciplinary cases and practice. We regularly advise on the use of contractual approaches as a first method of dealing with poorly performing practitioners.
We have been misappropriated public money. We have been able to mobilise speedily to obtain freezing injunctions and search orders working with PCTs since the inception of the Performers Lists Regulations. Difficult decisions regularly need to be made in relation to the inclusion, deferral, suspension or removal of a practitioner from the various PCT primary care practitioner lists. We have advised extensively on the implementation of the regulations in relation to all four practitioner groups, successfully representing PCTs on appeal before the FHSAA and assisting PCTs th r ough the often lengthy GMC and GDC processes that tend to track alongside these cases. We offer practical solutions to such matters and have a wide range of precedent letters that can be used to assist our clients in this. If a robust line is taken at the outset, the MDO representative will often defer or not undertake representation in favour of their client, the Performer.
We regularly advise PCTs in relation to the need to compete new GP practices. We also advise on the interpretation of the NHS (Pharmaceutical Services) Regulations 2005 and the Terms of Service in relation to pharmaceutical list applications for minor relocations, change of ownership and exemptions from the control of entry regulations. We have worked closely with a number of PCTs in relation to a number of contentious pharmacy applications in rural controlled localities and are familiar with both old and new processes.
In addiiton, we advise on a wide range of other pharmacy issues including clinical trials. We provide regular training and development seminars for risk managers, doctors, allied healthcare professionals and NHS organisations on a broad range of pharmacy matters.