ࡱ> :<9y cbjbjEE *''c KKKKK____ k_tZZZ2444444$' XKZZZZZXKKmZKK2Z2rTPC_pv0a!a!a!K ZZZZZZZXXZZZZZZZa!ZZZZZZZZZ :  LMC Discussion Paper on possible Process for Contractor appeals against a PCT decision 1.0 The Problem With the devolution of responsibility for primary care independent professional contracts to Primary Care Trusts s, we need to establish a clear mechanism for resolving differences between professionals and managers over contractual matters. This need is made more pressing by the increasing diversity and range of contracts, and also the larger number of PCT staff who will be dealing with them; many of whom are relatively inexperienced in this field. 2.0 Proposed solution After initial discussion with Taunton PCT, we suggest a tiered approach to resolving differences. 2.1 Local Resolution If the professional practice or practitioner and the relevant PCT manager cannot agree, the matter should be considered by the chief executive and the professional lead for the PCT (normally the chair of the PEC for medical practice matters). A face to face meeting should be offered. The practice or practitioner may wish to be supported by their Local Representative Committee at this and later stages. 2.2 External Review If agreement is still not reached, the practice or practitioner can ask for an external review. This would be undertaken by an appropriate manager and the lead professional from another PCT. It should be agreed that the decision of the reviewers will be accepted by both parties as definitive and hence normal business to go on as usual during any subsequent processes. It may be that for each non-medical professional area one particular PCT will acquire particular experience in contract matters. 2.3 Final Arbitration Either party may then ask for an Arbitration Panel to be appointed with one non-executive member from the PCT in dispute, one non-executive from the PCT that has reviewed the complaint, and one other member we would suggest the chair of an LRC not involved in the dispute. The decision of the Arbitration Panel would be binding. 3.0 National Appeals to FHSAA Although, for the present at least, disputes can still be referred to the FHS Appeals Authority, this has a number of disadvantages. The FHSAA can be very slow in considering disputes. The FHSAA has none of the local knowledge that can be vital in reaching the best decision. Referrrals to the FHSAA may be regarded by health authorities as demonstrating a failure of local relationships that implies criticism of both parties. 4.0 Next Steps We would like to see a single system for all contractor appeals agreed by the four Somerset PCTS. Once agreed with Taunton PCT, this paper to go to the other PCTs for their comments. LMC to discuss the contents with the LDC, LOC and LPC at the next joint LRCs officers meeting in July. If agreed by the PCTs and LRCs, the process to be formally adopted by both. Whilst the option of an appeal to the FHSAA cannot be removed from either party, the LRCs would undertake not to support such an appeal by a contractor unless this action had been agreed at a formal meeting of the LRC, and PCTs would require a formal board resolution to do likewise. 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