This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

David Palmer

  • Give English GPs as good a deal as in Scotland, GPC urges

    David Palmer's comment 22 Jan 2013 11:09am

    Minor but important correction to a comment above - exception reporting does not reduce income.
    The prevalence factor determines the £ per point for each QOF disease area. That factor is based on the on register size, which is not affected by exception reporting.

    Practices can therefore achieve 100% by showing that any patients that did not meet the QOF indicator where appropriately exception reported.

    BUT the key word there is appropriately. That's three invites / year ignored for 'informed dissent', or a very good clinical reason such as end of life for 'patient unsuitable'. Not we didn't get round to inviting them and it's now too late, or the patient lives in a nursing home (have seen both plenty of times).

  • A quick guide to de-registering patients

    David Palmer's comment 22 Jan 2013 10:49am

    This is a good article that clearly sets out the contractual requirements and pitfalls for practices, particularly the need to document all removals and the reasons for them.

    At least one high profile GP has fallen foul of this before, practices should bear in mind as inappropriate removals tend to be dealt with contractually by PCTs / NCB NATs (not by the GMC, as previously suggested by Pulse).

  • LMC warning after GPs submit blood samples under false names

    David Palmer's comment 09 Jan 2013 9:20am

    Is this not fraud?

  • GPs begin campaign against dementia screening DES

    David Palmer's comment 17 Dec 2012 7:36am

    In response to anonymous 14 Dec, your comment is more about prioritising areas/resources, whereas the story above seems to argue that screening is actively harmful to patients.

    Perhaps the campaign could benefit from a little clarity, unless this is another case of the Pulse headlines not quite matching the story...?

    PS. Best wishes for your retirement, I think we're all a little envious and will need that good luck!

  • GPs begin campaign against dementia screening DES

    David Palmer's comment 14 Dec 2012 4:18pm

    What a bizarre campaign.

    - Dementia underdiagnosis is a recognised problem.
    - Patients who do not wish to be screened can refuse it under informed dissent.
    - The view that there is no useful treatment is out of date, but even if true it would allow patients to prepare whilst they are still able.
    - A diagnosis of dementia allows access to a wide range of support services both for diagnosed patients and their carers.

    Or should we just rely on secondary care to diagnose the patients after they're admitted to secondary care and cannot be discharged?

  • GPC reveals list of 'unworkable' proposed QOF indicators

    David Palmer's comment 05 Nov 2012 4:44pm

    Presumably the issue is around the threshold?

  • GPC reveals list of 'unworkable' proposed QOF indicators

    David Palmer's comment 05 Nov 2012 4:44pm

    The third indicator on this unworkable list appears to be an easier version of current QOF indicator PP2?

  • GPs were promised a future of ‘blood, sweat and tears’ – and now it’s here

    David Palmer's comment 02 Nov 2012 8:52am

    A fair point, the above post should refer to effective salary, not take home pay. But that still can't be sustainable with the times of plenty are coming to an end.

    No profession could successfully simultaneously negotiate on GMS, PMS, APMS, QOF, LESs, DESs, premises and pensions at the same time and it seems foolish to try. Perhaps a better approach would be to demand a big ticket item in return, investment in the chronically underfunded primary care estate would be a good start.