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Revealed: GP practices face pay cut as DES uptake rates dip to 55%

Exclusive Many GP practices are facing a pay cut this year after they refused to sign up to the new directed enhanced services offered from April, indicate preliminary figures that show take-up rates dipping to 55%.

The figures obtained by Pulse from nearly 700 GP practices show that 45% have yet to sign up for the remote monitoring DES, and 44% for the online access DES.

The dementia DES was the most popular DES, with 59% signed up and 41% yet to inform NHS managers whether they will take part.

A Pulse survey published in January that found a third of GPs intended to reject all the four DESs proposed, funded by money cut from the organisational domain of QOF, effectively accepting a major cut in their pay this year.

The figures from two local area teams come as GPs in some parts of England have been granted an extension to sign up to the four new DES schemes - in some cases until September - in a move GP leaders have claimed demonstrates the folly of the Government’s contract imposition.

The GPC said that the figures from the Lancashire and Manchester local area teams showed take-up for the new DESs has been hit by concerns over the workload involved.

Some 379 of the 695 GP practices in these two areas had signed up to the remote monitoring DES worth £1,478 for an average-sized GP practice. Some 387 signed up for the online access DES, worth £985 for an average-sized GP practice, and 409 to the dementia DES, the most lucrative of the three at £2,587 for an average-sized GP practice. Figures for the case-management DES were not available, as this is being monitored by CCGs.

The Lancashire LAT has, like the majority of the northern area teams, decided to extend the deadline - but GPC deputy chair Dr Richard Vautrey said these initial figures suggested that practices are considering the ‘wisdom’ of taking on this work.

He said: ‘This would be a further pay cut for GPs, but many have concluded that they risked losing more by trying to do some or all of the DESs than they could potentially earn because the pricing of each DESs does not match the workload involved.

‘We knew that many practices would question the wisdom of doing these new ill-considered DESs. This is what happens when the Government fails to listen to GPC and the profession.’

The GPC has previously pointed out that the money that can be earned through carrying out these DESs is not ‘new’ money, having been removed from the organisational domain of the QOF when the Government imposed the current contract in April this year.

NHS England refused to supply sign-up figures for the rest of the country and blocked other LATs from responding to Pulse’s request for information saying: ‘Area teams continue to collate sign-up figures and final figures are therefore not yet available.’

DES uptake

59% - dementia DES

55% - remote care monitoring DES

56% - online access DES

Source: Figures covering 695 GP practices from NHS England’s Lancashire and Greater Manchester area teams

Readers' comments (7)

  • If practices choose not to provide a DES then they are bound to suffer a loss of income. What else would you expect?

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  • I think the poster above has forgotten that the DES is in place of QoF points that are lost. Some of these QoF were done by administrative staff which GPs employed but the same staff cannot do the new DES. Hence some practices who are already stretched at full clinical capacity had no choice but not to under take this meaningless exercise.

    That's where the beef is mate!

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  • Not quite true, The 'on line' DES is an admin function
    The others are Clinical

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  • Depends on the quality of the admin staff. My PM could have done it I suppose but she was too wound up with CQC.

    So I ended up doing all from doing up our web site, teaching staff on how to register patients to online system, making little guides etc. Done in my 'free' time over weekend and annual leave, wife complaining she's hardly seen me for a few weeks.

    Time that would have been better spent on being a clinician, rather than a make shift IT technician.

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  • With the Ever increasing cost of locum cover, it is just not cost effective to do all these things which require a GP/face to face aspect. The reimbursement is not worth it, so although as the headline states practices are loosing money sometimes they would be more out of pocket with the amount of work involved. Not to mention impact on patient access.

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  • To do them or not, excluding the online DES which is easy, is a business decision - value for money works both ways.

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  • every practice should now employ an IT technician - very cost effective

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