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GPs buried under trusts' workload dump

NHS England to make minimal changes to out-of-area scheme

NHS England has suggested minimal changes to the ‘out-of-area’ patient choice scheme used by private company Babylon to register patients from across London and Birmingham.

It has released its consultation on the future of scheme following its promise to review the scheme as part of 2019/20 contract negotiations.

The consultation rejects the idea of reducing payments for out-of-area patients, and for removing the premium given to practices for new patients.

However, it does suggest that there should be a delay to payments given for new patients, who will have to be registered for six months to a year before the extra premium is paid to practices.

Ed Waller, NHS England primary care strategy and contracts director, said in a briefing with Pulse: ‘We promised to look at a couple of the funding questions around the way we pay for primary care itself. In the contract we announced a change to the way we pay for rurality and London weighting.

‘We are looking around two more issues in this consultation. One is around whether we should continue to pay the same for in-area patients – ie, the ones inside the practice boundaries – and the out-of-area patients (OOA). And the second is whether we should continue the system we have now where we pay 46% extra per patient for new registrants.

‘On the first of those we have concluded that actually the amount of money that you might take away for someone’s OOA status (ie, because the practice is no longer obliged to offer home visits) is quite small and, in comparison to the scale of the exercise you’d need to do to rectify it, is not that material. So we are proposing on the basis of the current evidence to leave that alone so every patient continues to attract the same funding.’

He added that there are reasons for the premium given to new patients.

‘The idea is that people register when they have a healthcare need, and there is an extra load of work to register and deal with that.

‘There are lots of people who move practices totally irrelevant to digital first. So most of the movements are catered for on the current arrangements. The only thing we propose to change is that you need to remain registered with your current GP for some time in order to attract that extra payment, and we propose that should be six to 12 months.’

Simon Stevens has said digital services will help ease GP shortages.

Hammersmith and Fulham CCG approved GP at Hand's expansion to Birmingham with a limited list size of 2,600.

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