A retired GP
It will only take 10-20% of practices withdrawing to scupper PCNs because the remaining practices have to cover their work - Extended Access, Care Home reviews etc etc. Once a few pull out others will follow and PCNs will tumble like a house of cards. Expect NHSE to make major concessions in the next iteration to try and keep practices on board.
1.4% is not so bad when you take account of the 'one-off permanent adjustment' (i.e. recurrent adjustment) to cover indemnity costs. This will have a significant beneficial impact on net GP income.
Paul Cundy is right. And even if both practice have and use GP2GP, which they should, there can be problems with file size limits.
Our local hospital 'digitised' many of their (massive) paper records and, as anonymouse3 observes, they are difficult to use because they aren't properly indexed.
And you are all correct: this shouldn't be paid for by practices!
That's about 3-4 hours per GP. Over 2 years. We're saved!
I see that you approached the DHSC for comment. Why not just stick in the response they give you every single time? "A Department of Health and Social Care spokesperson said: 'We recognise the invaluable contribution of GPs and we are determined to build a strong workforce - that’s why we are investing an extra £2.4bn a year into general practice by 2021, with record number of doctors in training and NHS England planning to recruit an extra 2,000 overseas doctors.'"
Good pont, well made.
The GPC position is to pay reimburseable charges, but to dispute unjustified service charges - which have inflated ludicrously since NHSPS took over. There are several instances where these inflated charges have led practices to consider handing back their G/PMS contract, as it's uneconomic to continue working from their current building. This is desperate for the CCGs, as no sane incoming replacement provider would be prepared to take on the NHSPS lease conditions.
Not so sure SMT. Many leafy Tory shires voted for Brexit and appear to be the least hit by the current GP manpower crisis.
As a GP who timed leaving the pension scheme and then my practice to minimise AA and LTA liabilities I well understand silver surfer and Dr Mead. But this isn't the issue. The NHS only lost 2-3 years of my service.
The main problem is younger colleagues emigrating or leaving the profession altogether. Jones the Tie is spot on: no attempt by this Govt to address, or even understand, why nobody wants to do the job any more.
It's worse than these figures suggest. Looking in more detail, since the target of '5000 extra doctors' was set in Sept 2015, the number of FTE 'GP Providers' (i.e. partners) has fallen by 2046, which is 9.3%. Nearly 1 in 10 GP partners have left since the recruitment initiative was launched. A slight increase in salaried GPs and Advanced Nurse Practitioners has not bridged the gap. This is why practices are failing, and / or handing back their contracts.
For the reasons others have mentioned, being a GP, still less a partner, is no longer attractive. A fundamental rethink is required, and by that I don't mean a 3% pay settlement, or the GPFV nonsense. This means doing something real to address excessive demand / workload, overbearing regulation / bureaucracy, and serious legal jeopardy. Not faffing around with a few 'high impact changes'.
A new patient 'every 2 minutes'. That would be 720 a day, or 20,000 a month? Next, they say 4,000 new patients per month, yet list size only up 2,500 over the past year? Are lots of patients joining and then leaving again? The figures are clearly wrong. It would be interesting to know what the real figures are.
The CCG will experience financial pressure if there is a rapid increase in list size as they are liable for primary and secondary care costs. Their financial allocation will take a while to catch up, but I'm sure this will be managed across their STP.
There's too much at stake, politically, to allow this to fail.
I'd be interested to read NHSE's Equality Impact assessment which they no doubt conducted as part of this procurement. I should also be keen to understand how they will ensure that this GMS practice does not decline any patient seeking to register, nor unreasonably de-register any patient. Of even greater interest, if this initiative really takes off, will be the unintended consequence of thousands of low demand patients migrating and leaving other practices with the uneconomic residue of high demand, sick and frail patients. NHSE could be faced with a wave of practice closures and difficult reprocurements, which they will have brought on themselves.
Basingrad is correct. There has been some money locally to pay for Extended Access (extra work) and a little bit for 'resilience' and for 'training'. But there has been no substantive recurrent increase in actual practice funding at all.
It's hard to see how GPFV can work. Of the 5000 'extra GPs' by 2020, perhaps 2000 are needed to fill current vacancies: in other words they could be funded from existing budgets. But there is no money in general practice to fund the further 3000 GPs, even if they could be recruited. Let alone the 5000+ other staff. It just doesn't add up.
Mayur, the key point of the article is 'treat the cause, not the symptom'.
The GP Forward View is failing because it doesn't address this point. There is a near 8% annual wastage rate of GPs and no-one has yet asked why that is? Until we address the causes of GPs burning out and leaving the profession the workforce will continue to shrink and more practices will fail.
More resources, less workload dumping, reimbursed indemnity, less bureaucracy and regulation (GMC, CQC etc.). All seemingly unpalatable to NHSE, but vital if general practice is to survive.
Nothing has changed since this was published over a year ago.
Having been opposed to charging for many years I have now come round to the same view - a small charge is required to make the service 'valued'. Even a token fee for those who currently qualify for prescription exemption, perhaps £5? We all pay 5p for supermarket bags, and look at the impact that's had on demand!
I tried Australia, as an OOH locum, 26 years ago. Chasing the Medicare fees, and Private fee bad debts did my head in. Returned to the UK for its capitation model, and still believe its the best model. If issues concerning QOF, CQC, AQP tenders etc. (frequently discussed here) could be resolved, opinions might change.