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Gold, incentives and meh

Ministers 'have gone too far to drop target now'

The Government has stepped up its chronic disease management drive with the award of a £6 million contract to US company United Health Group to pilot the programme in cancer patients.

Subsidiary company Ovations will run schemes in nine PCTs to improve co-ordination of cancer services.

But the GPC questioned the need to pay private firms to run schemes that are little different to those already in existence and expressed 'a lack of enthusiasm' for the Government's programme.

The two-year pilots are expected to run along similar lines to the United Health Group's Evercare schemes, which employ nurses to manage patients with complex chronic diseases and are thought to have inspired the Government's controversial community matrons programme.

Diane Eden, implementation lead for cancer and palliative care services for Halton PCT, one of the PCTs involved in the scheme, said the pilots were based on the same principle as Evercare.

'It's about making sure patients get the right care, that they have the right medications and co-ordinating all the different services. And keeping patients out of hospital or if they do need to go getting them out quickly,' she said.

But GPC negotiator Dr Laurence Buckman said he wasn't enthusiastic about the scheme. 'Macmillan nurses already provide a service in the community. I want to know what is different about this scheme,' he said.

'GPs can always use more help so if they want to put more money into cancer care why don't they put more money into the Macmillan nurses?'

The GPC recently condemned the community matron programme as 'potentially threatening to the essential role of the GP' because of the plan that the 3,000 matrons should take on overall responsibility for patient care.

But Dr Robert Markham, a GP in York and lead for the Selby and York PCT pilot, said he hoped the scheme would improve co-ordination between primary and secondary care.

'GPs are involved very early on,' said Dr Markham, who is also a PEC chair. 'We need to figure out what else we can do to support patients in terms of psychological needs, improving care at home, and reducing unplanned admissions.'

By Emma Wilkinson

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