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Gold, incentives and meh

Dame Janet softens Shipman criticisms

GPs are resisting attempts to force them to take over outpatient follow-up for no extra pay to help hospitals cut multi-million pound deficits.

Under plans to be implemented this week in Surrey and Sussex, GPs will take over clinical responsibility for patients requiring follow-ups from consultants and will be expected to follow 'clear treatment plans'.

Practices across four PCTs will also be asked to report on the quality of the care patients receive from new 'interface' primary care services.

The scheme in Crawley, Horsham and Chanctonbury, East Elmbridge and Mid-Sussex and East Surrey PCTs is designed to bail out Surrey and Sussex Healthcare NHS Trust.

Dr Jeffrey Oliver, a GP in Crawley, said GPs felt deceived over the plan after managers revealed it just three hours before a primary care development group, which will not meet again until autumn.

'Apparently it's been discussed by the professional executive committee but it has not been discussed with local GPs,' he said.

He said his practice and others were writing to Crawley PCT stating they would refuse to participate unless the work was funded, perhaps as an enhanced service.

Dr Oliver said: 'I'm deeply upset that because of the financial mismanagement we are being asked to take on

additional work without funding.'

Dr Jeremy Luke, another Crawley GP, said he was prepared to tell patients he could not treat them if he thought their follow-up was more appropriate for secondary care.

'It's hard to say No but we are not prepared to do inappropriate work,' he said.

Dr James Gillgrass, secretary of Surrey and Sussex

LMCs, said GPs appreciated many follow-ups were inappropriate but it was not acceptable to dump work on to practices. He said: 'This is clearly a transfer of work from secondary care. It must be funded.'

Crawley PCT said outpatient follow-up rates were higher in the trust than in other parts of Surrey and Sussex and the rest of the UK.

By Ian Cameron

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