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Call for joint bonuses to force specialists to work with GPs

GPs and specialists should be forced to work together to earn joint pay bonuses as a reward for cutting hospital admissions, suggests a think-tank that is advising the Government on chronic disease care.

Researchers from the King's Fund say the quality framework will not be a sufficient incentive to cut preventable emergency admissions for chronic disease.

The Government's politically-motivated obsession with cutting elective waiting lists means chronic care is neglected, concludes their report published last week. 'There is scope to develop financial incentives that more clearly link primary and secondary care together in the shared endeavour of chronic care ­ for example joint incentives to reduce hospitalisation,' it adds.

Report co-author Dr Rebecca Rosen, a GP in south-east London, said joint pay incentives were needed.

'Quality and outcome payments are a good start but they are only a partial solution,' said Dr Rosen, a fellow at the King's Fund.

The researchers analysed how US health care management organisations, such as Kaiser Permanente, have cut emergency admissions with pioneering strategies to improve chronic disease care.

Earlier King's Fund research has found that around one in 20 winter emergency admissions is caused by exacerbation of a chronic lower

respiratory disease that could be prevented by better GP care.

The King's Fund is part of an NHS Modernisation Agency coalition that is working to improve standards of chronic disease care.

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