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Gold, incentives and meh

Anyone else lost heart with the new contract?

Am I the only one feeling very disillusioned with the new contract? I assumed that if we signed the contract it was fixed and binding, but obviously that premise is wrong.

Sutton and Merton PCT wishes to change IUCD fittings from a national enhanced service to a local enhanced service, so it can set its own fee.

It also wishes to deduct £10 on the basis that chlamydia screening, which costs £10, should be performed prior to insertion.

Surely it is not appropriate to screen every woman and I would also argue that the insertion fee pays solely for my time and expertise in fitting the coil.

The service outline also mentions regular yearly assessment.

Most women will attend for a six-week check but up until now it has been standard practice to offer the choice of either an annual review or returning if they have any worries or problems, until the coil is due for changing.

The requirement for annual review seems to go against patient choice.

My biggest disagreement, however, is that GMS practices are actually being disadvantaged compared with PMS ones.

Our PCT is suggesting paying PMS practices for coil insertions, albeit at a reduced rate. My understanding is that a PMS contract already includes the cost of coil insertions and that this was set when these practices signed their contracts.

PMS practices also receive growth money.

If this goes ahead they will in effect be paid twice for coil insertions even though they are already better off. How can this be equitable?

If the minister wished things to be truly equitable he would be advocating a percentage of growth money for GMS practices.

The money available for local enhanced services should be used first to pay for the extra services that GMS practices currently offer which are outside the contract. PMS practices already get paid for existing extra services in their contract and should not be paid twice.

Any money remaining should then be used by both types of practice to fill local needs.

Dr J Munden



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