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Are QOF points the answer to partner shortages?

Rewarding continuity of care is among the more unusual ideas for boosting the supply of partners

By Richard Hoey

Rewarding continuity of care is among the more unusual ideas for boosting the supply of partners

It's interesting the variety of views that Pulse's One Voice campaign has elicited so far.

Obviously there are the militants from either side - those who think all partners are serial abusers, or who regard salaried GPs as wasters who are pushing their luck.

But there is also variation on an even more fundamental question than that – whether the apparent divide between partners and sessional GPs actually exists at all.

Over the last few days, I've talked to a couple of senior leaders of general practice, both of whom head their respective organisations.

One believes general practice is in crisis, and in danger of leaving a broken legacy to the next generation.

The second has a very different view. He believes there is no real issue, and that some of those who claim there is may have vested interests for doing so.

For some individuals, that might well be true.

I can imagine some doctors facing performance pressures might find it easy to blame blanket discrimination for their plight.

But that doesn't explain the strength of feeling among general practice as a whole.

Our survey, just to recap, found nearly three quarters of the 500 plus GPs who responded felt the divisions were damaging for the profession.

More than 80% of all GPs – partners and salaried GPs alike – felt something needed to be done with the GP contract to encourage the creation of partnerships.

Where everyone seems to get stuck, is precisely what. A new version of the red book? A carrot and stick approach by PCTs? Or a new consultant-style contract that can put salaried GPs on an even footing with partners?

All these have been mooted, but here's an idea from left field (or to be more specific, the NHS Alliance) that I quite like.

How about offering QOF points for continuity of care?

There is good evidence that partners offer better continuity than salaried doctors, and particularly that those organisations relying on large numbers of salaried GPs tend to struggle to offer patients the option of seeing the doctor they know.

If we start incentivising continuity, we incentivise partnerships at the same time.

In a profession where divisions are leaving both sides the losers, that sounds to me like a win-win.

By Richard Hoey, Pulse editor

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