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Make a push for organisational points

Dr Bob Button says GPs should make a real effort to achieve the 284 points for organisation and patient experience

One of the real advantages of the new contract is the way it enables GPs to receive payment for what they are already doing. It also encourages them to take action they know they should be taking – by paying them for it.

Quality and outcomes payments have been clearly recognised as a good source of future income. Being doctors, GPs have tended to concentrate on the clinical aspects of these payments: in some cases they have not given adequate attention to payments available for the organisational aspects of general practice and patient opinion of the practice.

Altogether 1,050 points are achievable under the Q&O scheme, and a quarter of these come under the organisational and patient experience headings.

When you think that only 36 points are available for additional services, it shows you how profitable it would be to make a real effort to achieve the 284 points under the organisational and patient experience headings – especially when twice the additional services points are available under the patient experience section alone!

Providing professional service

The patient experience section involves two parts – an analysis of consultation length and a patient survey. A colleague once suggested the following: GPs should put 'I should not' before a suggested action and ask whether by taking this course of action they would still provide a professional service. Why not try this in the patient experience section?

Any GP with a professional approach will surely recognise that these are not only valuable to achieve in terms of financial reward but are also part of our responsibility as professionals in delivering the best possible care.

Under consultation length, the aim is for an average consultation of eight to 10 minutes. Most GPs would agree this is a fair amount of time to provide to the patient. It is a professional standard that most would aspire to, so we should be well pleased when the Government offers us payments to achieve it.

Full details of exactly how to analyse the patient experience element of Q&O payments are to be found in the extended Blue Book in section 4.

Patient surveys could gain you 70 points.

It has always amazed me that we do not

place greater emphasis on checking on what our consumers think of us. In the area of patient choice, where the Government is determined that patient opinion about the health services they receive has paramount importance, no practice can afford to ignore what patients think.

The points target is achieved by three different actions, which in a well-organised practice will not require the doctor to do very much at all.

First, carry out a patient survey. You can find examples of these in the large Blue Book. The two approved surveys are the GPAQ and the Improving Practice Questionnaire. The latter is copyrighted and has to be processed by its designers. This involves the payment of a fee, but since the return in terms of financial gain is much greater than the fee to be paid, it is well worth doing.

Merely performing a survey and getting returns from at least 25 of the questionnaires per 1,000 patients gains you 40 points, but you must remember that if you get fewer than this number returned you don't get any points at all. There are no rewards for just trying.

Reflecting on the results

If you and your practice team then reflect on the results of the survey and determine actions to be taken to improve your services, you will gain yourself a further 15 points.

Were you to go further still and include in the practice team survey discussion either a patient group or a non-executive director of the PCO, then a further 15 points can be yours.

The surveys have to be done over a relatively short period and for this reason are not likely to prove a great burden, but they do need organisation. Your administrative staff, led by your practice manager, can do this. For you it will merely mean a meeting later in the year with all the partners present.

And bear this in mind – there appears to be nothing in the rules to prevent the meeting of the team to consider the survey being held in a local hotel accompanied by a pleasant meal. There is no reason in fact why you could not seek sponsorship for it as well.

Bob Button is chief executive of Wessex LMCs

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