In perspective - influencing the local agenda

Physios in the private sector can help NHS colleagues in the changing NHS environment, says Judith Pitt-Brooke.

In May this year, my area – Leicestershire – launched its procurement invitation on the NHS Supply2Health website.  

I have always had great working relationships with local GPs, delivering well-respected services to NHS patients from our private practice.

This led me to believe that any qualified provider (AQP) might offer our practice the opportunity to extend these benefits, enabling patients to access the best of the local well- established private providers and the best of our local hospital physio care.

I’d experienced a sensible NHS contract recently – one with a fair tariff set out for a waiting list initiative.

To my horror, I turned the pages of the AQP procurement document to find a long set of poorly worded material peppered with disjointed and contradictory information – and a tariff cut by 40 per cent on the recent contract.

This would barely cover the cost of employing a band 5 physio, let alone anyone else. This, I thought, exposed the profession to ridicule.

A call to the GPs’ musculoskeletal services lead for our area showed he had not even heard about AQP! Letters of concern  to both co-chairs on our clinical commissioning croup (CCG) received no response.

A call to another member of the CCG indicated he was ‘aware’ of the  tariff  and when questioned, confirmed it had been set to ensure ‘value for money’.

Discussion of the basic maths against simple employment costs, and the quality requirements set out in the contract documentation, showed he had little knowledge of facts or figures.

Appalled, I wrote to my MP, Nicky Morgan, who responded  immediately.

With her support and encouragement, we pursued some of the challenges.

We forwarded letters to Conservative MP Simon Burns, who responded directly. All this was very encouraging.

Calls from other practitioners, in both the NHS and private practice, showed they were horrified by the tariff as well.

So we persisted, together, but independently, contacting more GPs and influencers.

The key was that we all knew the tariff was not economically viable. Did we just accept it?  

We shared a view that quality and professional reputation are ‘king’. Physiotherapy businesses grow or die on this – and the same applies in the the public sector.

So, what price for physiotherapy?

In Leicestershire, we chose to fight for a fair price. And here the next chapter starts.

At present, our CCGs cannot deliver back and neck pain services under AQP, because we all said ‘no’.

We now have the opportunity to help our service commissioners understand better how best to deliver wider patient choice and develop the best physiotherapy benefits that tax payers’ money can afford.

Judith Pitt-Brooke is a founding partner at East Midlands Physiotherapy Clinic, Loughborough, and a CSP council member.

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