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I'm bewildered by this anticoagulation fee

My copy of the new GMS contract sent by the BMA stated there is to be a 'nationally enhanced service' of which anticoagulation monitoring is one and that there is a list of

fees for these services with the range being £80-£110.

When I pointed out to the BMA that I, like many if not all local colleagues, have for years been providing this service for no extra remuneration from the NHS, and that the correct range of fees therefore, on the basis of what GPS have in the past been paid, should perhaps be £0-£110, I was told to ask my LMC to help me with my negotiations. But for years the LMC has tried to negotiate fees for this service ­ unsuccessfully.

When this matter was raised recently we were told we should stop providing such service if money ­ negotiated fee that is ­ is not forthcoming from the NHS. But I do find all this bewildering. What a strange sort of contract this seems to be. Perhaps other doctors have understood it better?

Dr John Hawson

Windermere

Cumbria

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