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GPs accused of undermining choice agenda

By Gareth Iacobucci

GPs have been accused of contributing to the failure of the Government's choice agenda, by failing to offer patients sufficient options through Choose and Book.

A wide-ranging report on Government health policy by two leading watchdogs found many reforms had failed to have the desired impact on patient care, with choice singled out as a particular damp squib.

The report, by the Audit Commission and the Healthcare Commission, claimed GPs were being rewarded despite failing to offer patients suitable choice of outpatient appointments.

It urged PCTs to adopt a tougher stance on payments, and called on the Department of Health to redesign incentives to GPs for offering choice.

Earlier this year [check], Pulse revealed PCTs were ploughing millions of pounds into LES payments to support use of Choose and Book, after the Choice and Booking DES ended.

But the report Is The Treatment Working? concluded: ‘We were unable to find any convincing evidence that incentive payments made by PCTs for GPs to offer are delivering value for money.'

The authors estimated the full range of Government health reforms – also including payment by results, practice-based commissioning and introduction of independent sector treatment centres - had cost as much as £1bn to implement.

But the impact of the reforms had been disappointing, with PBC also criticised, for failing to bring redesign of services or transfer of care from hospitals to the community.

Sir Ian Kennedy, chair of the Healthcare Commission, said: ‘It's clear the reforms have not yet achieved what was promised and that progress is behind what some might have hoped for.'

GPs were focusing on ‘providing profitable services, rather than on commissioning innovative services or dealing with health inequalities', the report said, mirroring criticism last year that practices had targeted ‘low-hanging fruit'.

But Dr Richard Vautrey, deputy chair of the GPC, said the criticisms were ‘deeply unfair'.

‘There's clear evidence from the Government's own survey that patients are offered choice.

‘We remain concerned PCTs are not empowering GPs to engage in PBC. I think it's unfair for the Healthcare Commission to suggest that GPs are not interesting in commissioning.'

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