Posted by: Tony Copperfield23 April 2015
Forgive me, Father – and Mother and Sister and Brother – for I have sinned. But this confession comes with built-in repentance in the form of a cash bonus for all of us.
To explain: my practice has always taken a high-and-mighty self-righteous line on the dementia DES, viewing it as clinically inappropriate and unethical. But a recent glance at our bank balance led to some profound soul and cash searching, and a conclusion which could be summarised thus: ‘Sod morals, let’s make some money.’
I know, 50 Hail Marys and all that. It’s the Government’s fault, though. Such is its current obsession with Alzheimer’s et al that general practice is fast becoming a scene from Dawn of the Demented. Actually, that’s Dawn, Dusk, Morning, Afternoon and Working Lunch.
And if my practice doesn’t start toeing the line, we will miss out big time - not only on DES cash but also on a whopping great 50 QOF points.
So here’s the cunning plan. Having read the dementia DES specification I realise, for the first time, that the payment schedule is a bit weird. There’s the upfront cash, which is fine. But then there’s a pool of money – a breezy £21,000,000 – to be divvied up between us depending on how many dementia checks we do. The fewer dementia assessments we all perform, the greater the payment for each one.
This is where it gets interesting. Extrapolate that concept about as far as it will go. In other words, just suppose that only one dementia DES assessment is done in England in 2015-2016: then that single check will earn £21m.
To atone for my sin, I’ll volunteer to do this one dementia check while the rest of you put your feet up.
And what’s more, I’ll share the money with the rest of you. Ethics intact, workload zilch and about £500 each.
It’s a demented idea. But you have to fight fire with fire.
Dr Tony Copperfield is a GP in Essex