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Enhanced services go as PCTs try to cover referrals cost

PCTs are cutting enhanced services in response to the financial crisis caused by the apparently inexorable rise in GP referrals.

Practices at cast-strapped trusts look set to miss out on the promised increase in enhanced services funding, which is supposed to compensate GPs for successive pay squeezes.

GPs in Exeter have reacted with fury after Devon PCT revealed it was cancelling enhanced service payments for minor injuries. The trust has been hit by a £14.4 million deficit in part because of the increases in referrals.

From 1 April, patients will now have to travel to a minor injury unit, walk-in-centre or a new GP-led health centre to be treated. It follows moves by NHS Hammersmith and Fulham to also reduce enhanced services and to cut spending on its QOF plus scheme.

Dr Adrian Midgley, a GP in Exeter and member of the local LMC, said the PCT was either ‘clever and hard-nosed', or simply ‘broke and desperate.'

He said: ‘A cynic might say that practices may carry on providing the service even if they are not being paid to stop people going to the Darzi centre.'

Dr Adrian Renouf, a GP in Exeter, said: ‘This is penny pinching. I understand we have to save money, but of all the budgets to take money off, this wasn't the one. It's completely going against the flow of taking care out of hospital.'

Simon Tapley, assistant director of primary care at Devon Primary Care Trust, said the trust would be stopping payments to over 20 GP practices ‘in areas where patients may reasonably be expected to attend a nearby minor injury unit or walk-in centre'.

He added: ‘We are listening to people's concerns but this proposal will free up GP practices to do what they do best – providing treatment and care for people with chronic illness.'

PCTs are stopping enhanced services as they try to cover the cost of rising referrals

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