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GPs buried under trusts' workload dump

GPs offered cash bonuses to hit swine flu uptake targets

By Lilian Anekwe

Exclusive: GPs at the centre of one of the summer's swine flu hotspots have been offered bonuses worth thousands of pounds extra for hitting vaccination targets, Pulse can reveal.

NHS managers in Birmingham are so worried about the prospect of a winter outbreak that they have offered practices up to 50% over and above the payments agreed between the GPC and NHS Employers if they vaccinate a high proportion of the population.

The revelation came as Pulse learned the Department of Health has given PCTs the power to impose financial penalties on practices if they are forced to suspend routine work, raising fears GPs will be treated starkly differently by NHS managers during the outbreak depending on where they work.

NHS Heart of Birmingham revealed a sliding scale of bonuses, on top of the £5.25 practices will get per vaccination of patients in target groups and the relaxation of QOF patient survey thresholds if they hit the DH's uptake target of 50.7% in at-risk patients under 65 years.

A spokesperson for the PCT said: ‘In recognition of the additional workload, the PCT will pay a high-coverage bonus.' GPs will get a bonus of 10% even if they are 20% down on the Government target, and if they achieve more than 90% coverage the bonus will rise to 50%.

Dr Robert Morley, executive secretary of Birmingham LMC and a GP in the city, said the extra payments were ‘welcome'. ‘We are asking every practice to give us information about the burden of work so that we can arrange payment if necessary.'

Pulse, however, has uncovered documents issued to PCTs by the DH, giving trusts the power to impose financial penalties for the ‘cessation or reduction of clinical services'.

PCTs are also being encouraged to visit practices unannounced to check that the workload pressures or staff absences given as reasons for suspension of services are genuine and ‘to validate them at any time during or after a period of service suspension'.

The new guidance documents – distributed to PCTs by NHS Primary Care Contracting, a policy-implementation body acting on behalf of the DH – fly in the face of Government guidance issued to PCTs in August.

That document, Pandemic Flu: Planning and Responding to Primary Care Capacity Challenges, encouraged trusts to pay practices that were forced to provide cover for neighbouring practices under buddying-up arrangements up to £1,250 per 1,000 patients and advised that ‘the PCT should not take any action to recover monies paid during the period the practice is closed'.

A DH spokesperson said: ‘It is only right PCTs and GPs are well prepared for all circumstances.'

Swine flu cases in England rose by 8%, from 78,000 to 84,000, last week. GPs have begun the task of vaccinating those in at-risk categories.

Last week, amid calls from the Conservatives, the Government announced it planned to extend the vaccination programme to children aged between five and 16.

Swine flu vaccination: how GPs are funded is likely to vary by area to area Swine flu vaccination: how GPs are funded is likely to vary by area to area Birmingham's swine flu bonus plans

30-49.9% coverage – bonus of 10%
50-59.9% coverage – bonus of 15%
60-69.9% coverage – bonus of 20%
70-79.9% coverage – bonus of 25%
80-89.9% coverage – bonus of 30%
90-99.9% coverage – bonus of 50%

Source: Heart of Birmingham PCT

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