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Ensuring you get full maternity fee

The Red Book contains many ambiguities and there has always been non-uniformity in how different PCTs chose to interpret the rules.

The wording for full and partial postnatal fees (para. 31.6 and 31.13-15) does not actually say a GP attendance is required but neither does it say a midwife attendance is acceptable.

Many PCTs interpret the wording for full postnatal care to mean at least one postnatal 'attendance' must occur in the first 14 days and this must involve the GP rather than an attached midwife.

However, at the same time some PCTs choose to interpret 'attendance' as meaning a face-to-face GP contact as a result of a visit or surgery consultation.

If GPs do not see the patient at all within the first 14 days of confinement but fulfil all the other criteria, many PCTs will only pay for a postnatal examination, losing £34.65 per patient.

If you want to make a stand, ask the LMC for advice ­ if it feels you have a case it may pursue it on your behalf.

You could consider asking patients to

visit you at the surgery within 14 days of delivery, but be prepared for a proportion of non-attenders.

Finally, you could bite the bullet and start routine visiting again, remembering that other fees such as contraception can be tied up at this time and the importance of the postnatal examination is emphasised.

This may only be necessary for a few months if the new contract starts in 2004.

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