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GPs demand action as patient survey robs practices of cash

By Gareth Iacobucci

GPs are set to launch a UK–wide battle against ‘devastating' cutbacks brought about by the Government's patient access survey, after it emerged it will rob practices in the most deprived areas of the country of thousands of pounds of funding.

Some practices are already reporting losses of up to £16,000 following the release of the first wave of findings from the revised Ipsos MORI survey, which is now entirely conducted by post, rather than in GP surgeries.

Many more are to lose almost £10,000 a year, with evidence emerging that it is practices in the poorest areas of the UK being hardest hit.

As from this year the £8m survey rewards practices via the QOF rather than through a DES, with practices income dependent on two sets of questions covering rapid access and advance booking, sent to a random sample of patients.

But GPs are warning that the response rates in many areas of the country have been so low that the views of just a tiny minority of patients are having a damaging and disproportionate effect on practice income.

Now the BMA is urging GPs who stand to lose thousands to stand up and fight against the results.

GPC chair Dr Laurence Buckman urged the Government to act ‘as a matter of extreme urgency' and said GPs who lose out should appeal, which the GPC understands they are entitled to do for up to three years.

The BMA predicts an average-sized UK practice could face losses of £7,500 but Dr Buckman added: ‘The financial impact on some practices has been huge and unfair. For a practice to lose a large amount of funding because the survey methodology is flawed is appalling.'

Pulse has learned that practices in deprived areas could be most threatened by big losses, after the first figures to be released -from Scotland - showed practices in relatively affluent areas had larger response rates, reducing their risk of results being skewed.

Glasgow and Clyde had a response rate of just 43% compared with 66% in Orkney.

Dr Natalino Marcuccilli, a GP on the outskirts of Glasgow, said his practice lost out on £16,000 because of 51 responses from a practice list of 18,000.

‘It's a tiny number to be judged on,' he said. ‘It's a major concern and is demoralising on our doctors. You feel you've worked hard and are being slapped down.'

Yet in Scotland, 90% of respondents overall – the current Government target - were satisfied with access to appointments within 48 hours. Three quarters of patients were able to make pre-bookable appointments three or more days in advance.

A Department of Health spokesperson said the survey was ‘robust' and was agreed with a stakeholder review group that included the GPC.

‘The methodology and sample sizes do not materially differ from previous years' surveys,' he said, adding that only in exceptional cases would primary care organisations be able to make payments to practices to compensate for particularly low survey responses.

How the new survey works

- The GP patient survey (formerly the Patient Experience Survey) was introduced in 2006/07 to support PCT assessments of GPs against national standards set out in DES agreements. It was initially given to five million patients at a cost of £12 million. During this period, GPs were also rewarded with QOF points for taking part in a separate quarterly PCT access survey.

- However, as of this year, the surveys have been merged in England and Northern Ireland, to become the new quarterly GP Patient Survey. Patient survey payments in all four countries are now delivered via the QOF, instead of a DES.

- Whilst the previous survey was given to practices when they went for an appointment, the new survey is now posted to a random sample of registered patients.

- In England, it is being sent in four quarterly chunks to 5.7 million patients. The DH says more patients will be receiving the survey than in previous years.

Dr Natalino Marcuccilli: loses £16,000 thanks to 51 responses out of 18,000 Dr Natalino Marcuccilli: loses £16,000 thanks to 51 responses out of 18,000

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