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Independents' Day

Government toughens stance on patient survey

By Gareth Iacobucci

The Government has toughened its stance over the controversial GP patient survey, by insisting that ‘one response is enough' to determine payments to practices.

Pulse revealed earlier this week that practices are facing devastating losses of as much as £25,000 from the revamped survey, due to a combination of tougher payment thresholds in the QOF and low postal response rates in some areas.

The Department of Health previously advised PCOs that they could make ex gratia payments to practices where the number of survey responses may be particularly small in relation to sample size.

However, in fresh guidance issued to NHS bosses, the DH now claims that trusts have no legal case to answer.

The Government has also attempted to pour cold water on any possible legal challenges, advising that while GPs can appeal payments, they cannot appeal survey results.

This comes despite the GPC advising practices to consider appealing to their PCOs if they feel survey results do not accurately reflect the access they offer.

The DH guidance, which offers a robust defence of the survey's methodology, follows widespread anger over the newly-revised survey, with GP leaders warning that only a handful will escape without financial losses.

The GPC has advised GPs not to delay sign offs of QMAS, even if they are planning to appeal or raise a dispute, as this could delay other QOF payments.

The DH said it was up to PCOs to consider the relative merits of individual disputes, but said there was no precedent for taking the number of responses into account.

It said: ‘Neither the Statement of Financial Entitlements (SFE) nor the QOF guidance contain stipulations or conditions about confidence intervals or sample sizes to be achieved. The SFE does not require a minimum number of responses to generate a result; one response is sufficient.'

The guidance also warns PCOs that they cannot enter different survey scores into QMAS, regardless of the grievances of individual practices.

It advises: ‘Where a dispute is raised by a practice over the achievement levels indicated through the GP Patient Survey, the PCT should not hold up making the payment they have determined but should authorise payment through QMAS as soon as possible so that QOF achievement payments are paid before the end of June.

‘The PCT should then manage any dispute raised through the normal dispute resolution procedure.'

Trusts are also advised that practices cannot appeal against survey results - only the payments associated with them.

‘GP practices can appeal payment made to them under the relevant provisions of the Statement of Financial Entitlements, but cannot appeal the results of the GP patient survey.'

GP patient survey

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