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Gold, incentives and meh

GPs demand action to stem leak of cash into secondary care

Better pay for GPs working for primary care trusts is essential if the Government wants more secondary care work to be shifted to primary care, ministers will be told this month.

The warning comes in a document from the GPC, RCGP, NHS Alliance and National Association of Primary Care aimed at stemming GPs' disillusionment with PCTs and stopping cash leaking from primary to secondary care.

The organisations said GPs had to be given a central role in redesigning NHS services but were put off working for PCTs because of poor pay rates and frustration that cash meant for primary care is being used to cover hospital debts.

GPs are paid £6,962 a year for sitting on a PCT professional executive committee.

The unpublished paper puts forward a series of recommendations aimed at transferring more work to primary care.

It calls for primary care-based referral teams staffed by GPs with a special interest to be set up so patients can be seen more quickly than with a consultant referral.

GPs would triage patients either over the phone or face to face, give second opinions or treat patients without

involving hospital consultants.

If the new GMS contract comes into force, the work would be a local enhanced service and therefore more money would remain in primary care, the document states.

Dr Michael Dixon, chair of the NHS Alliance and a GP in Cullompton, Devon, said money saved paying for referrals to secondary care could be used in primary care.

He said: 'GPs really should be quite radical and proactive in making sure they have a proper say in commissioning and spending discussions.'

Dr Julian Neal, chair of the GPC primary care development sub-committee and chair of the working group overseeing the document, said GPs working for PCTs had been 'living under the shadow of secondary care debt' and were frustrated at not being able to do more for primary care.

'PCTs have not put primary care in the driving seat at all,' he said. 'They have been constrained by other events, but need more autonomy and freedom.'

The document also advises trusts to bring hospital doctors into talks on redesigning services, though not on to the PCT boards.

It also recommends projects be scrutinised by bodies such as the NHS Modernisation Agency to ensure funds are spent in primary care.

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