Weekly news round-up: The unflushable stool

Questionable incentives

Pulse released a major investigation today into the cash incentives that GP practices are being offered to reduce pressure on elective hospital services.

Most of these schemes are above board and simply pay practices to peer review referrals, but a minority offer controversial payments linked directly to changing GP behaviour.

GPs are being offered up to a 50% cut of any savings made in some areas. In areas, £5 per patient is are being offered if GPs reduce their referrals by at least 10% – a scheme described as ‘unsafe’ by the local BMA GP representative – and one including cancer referrals.

And these are the ones that are causing concern. I doubt any sensible GP would allow a payment such as this to influence their decision-making, but the problem is the lingering suspicion that they leave in the consulting room and and the damage that can do to the relationship with a patient who may not feel confident their best interests are being put first.

The irony is that this is occurring while GP referrals are dropping. So do your colleagues a favour – if you are offered one of these schemes, please turn it down.

Losing the popularity contest

Patients love their GPs. Although recent research shows perhaps not quite as much as they used to.

GPs are no longer the most popular NHS service after public satisfaction dropped to the lowest level on record last year. A survey, of over 3,000 adults in England Scotland and Wales, found that only 65% were satisfied with GP services in 2017, compared with 72% in 2016.

The four main causes of dissatisfaction were staff shortages, long waiting times, lack of funding and government reforms. Which funnily enough are probably also GPs’ grumbles about their own profession, so at least patients and their family doctors are now on the same page.

Safety first?

The health secretary has been busy this week announcing a scheme to ensure that the NHS is the ‘safest healthcare system in the world’. The new national system will link GP prescribing with hospital admissions data for the first time to trace prescribing errors.

The move comes after a Department of Health and Social Care-commissioned study found nearly three-quarters of the 66m potentially clinical significant medication errors were in primary care, and linked them with around 600 deaths.

Mr Hunt announced the scheme as he attended the World Patient Safety Summit in London, where he received the ‘humanitarian award’ for global leadership on patient safety.

Although, of course some overly cynical commentators have said that his time would be better spent fixing the staffing crisis in the NHS, reducing waiting lists and ensuring the service has the investment it needs, rather than collecting shiny gongs (I am paraphrasing here…).