is it just a coincidence that my friend over here at 'keep paying more guv' is a seller of wheel trims and was asking how he could make a few million?
He does have big speakers, and fluffy dice too. All available at a good mark up over cost, and with extra longterm lending which means you get to pay for them long after they have fallen off.
..and what were the criteria for funding again?..
..and how long are they funded for?..
..and then they are funded out of practice savings.. oh I see, another pay cut.
How was it you thought this would boost morale?
As your article implies, they have already been assessed. CQC assessments have been based on registered address. The failures of each service have been hidden by moving registered address.
The response that CQC assessment's are 'unfair' is true. As it is true for every service that this organisation assesses. As a 'quality' organisation, CQC should be expected to understand how to write consistent reports, which are accurate, and measured against published standards. They should have a standard policy for review of demonstrable inaccuracies. They should have inspection approaches in primary care which address the multiple ways services are provided. They need to inspect single handed practices differently to GP lead multisite organisations.
Or they need to accept that their organisation is not about quality, but control, fear and intimidation with the aim of pushing General Practice into extinction.
'A provider survey' will have been completed by the relevant manager. In hospitals and other services this will be someone with no idea about the impact of CQC on professionally run organisations. In many cases it will be someone who feels that they need to put the 'right' answer to continue their career.
Have they any idea what their baseline variability is for any of the services they have studied?
That it is less than last year means almost nothing, while it is nice to have a 'control' it is essential to identify how the 'intervention' differs from the control.
Is this is an opportunity for academic GPs to establish some credibility? Is the college able to take an academic lead when it is so involved in the cheerleading?
..of course the questions were 'does this contract address..'. Which it does. However, the questions do not ask 'does the contract successfully do anything...'
The survey does not even ask if these people would support the contract, or if it is on the right lines...
This Hurley Group product, econsult, is being taken around the country as a perfect fit for NHSEs Hi Impact Actions and 5 year forward view.
'to enable more efficiency, and productivity' ie for practices to do more work.
The money for health continues to be given to private shareholders with no health benefit for patients. The NHS would be more affordable if we didn't keep giving its funding to these parasites.
'private finance' is what has always funded GP. Partners invested in a viable business model willingly when there was a future and a reasonable return. Now with a deliberate policy of destruction and underinvestment it is no surprise that only 'loan sharks' are available to provide high risk, 'arm or leg' type investment.
This is an expensive inefficient policy. It is the inevitable result of a complete lack of knowledge, interest and investment in a once exceptionally efficient and effective system.
Has anyone done research comparing how much money is spent on direct patient care when the money is given to the ccg as opposed to being given directly to practices?
The assumption that 'GPs just pocket the difference' is quite lazy, and may be difficult to justify when so much of what is supposedly given to CCGs for primary care is 'topsliced' and generally accounted out of existence.
It would be kind of the NHS to pay back to doctors the costs we have paid for our own training, but I think it probably an unhelpful suggestion.
Where would the money come from? further efficiency savings?
Could all surgeries who have on the day appointments be charged at the higher 'unscheduled' rate?
Appropriate risk sharing is important to help balance costs. Moving the frame around the risk will only highlight other costs.
Why not have a higher rate for practices where GPs share care more often? or practices where there are less 'traditional' or comprehensive consultations? Charge more for one off consultation cover?
Each of these changes are political, supporting one group, and direction of change over another.
The overall cost of the insurance risk remains higher than the system is prepared to pay. The expense is being wrung out of those in the middle. Those who already carry the clinical and emotional risk.
This all contributes to retirement, and emigration and a failure to recruit.
Of course there is still lots of money for Apms practices, but they don't have to be run by GPs.
This makes them miraculously more efficient, and worth every penny of the extra money they get to redistribute to their share holders. Of course to make any profit they do have to employ t he cheapest possible staff, but who cares as long as the economy benefits....
what? The shareholders and corporations may not contribute to the local economy. They are 'offshore' or registered in Luxembourg oh so the taxpayers are benefitting Luxembourg that's nice it is such a small place.
It is important that the list is not lost. Even if the provider and their compliance with CQC policy demands have been 'unsatisfactory'. The responsible commissioner, whether NHS E, or a delegated CCG, needs to keep this list and identify a new provider.
This is a situation which may become more common. Sending patients away and locking the doors is not a viable option. There needs to be a system in place for ensuring an interim caretaking situation, and a rapid, replacement if that becomes needed. Would the LMC and CCG be in a position to develop this?