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Wednesday 23 May 2012
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DH refuses to rule out using GP contract cash for quality premium

By Gareth Iacobucci | 20 Dec 2011

The Government is refusing to rule out raiding GPs' core contract payments to fund the controversial quality premium to pay GPs for commissioning.

The Department of Health has stipulated that the payment to incentivise GPs' commissioning performance will be funded from existing NHS resources, with many expecting the money to come from future CCG commissioning budgets.

But the Department has refused to rule out delving into GMS and PMS funding, which would potentially place thousands of GPs core income at risk. 

It comes after Pulse reported warnings from medical accountants that primary care funds would be raided to fund the ‘bonus payment', which will pay CCGs for the quality of services commissioned, outcomes and reduction in health inequalities.

The refusal to commit to protecting core GP funding will heighten fears of a fresh raid on GPs income, following six pay freezes in seven years and against a backdrop of spiralling expenses.

The Government made clear in recent evidence to the Doctors and Dentists Review Body (DDRB) on GPs' pay that it will proceed with the quality premium, despite staunch opposition from the BMA, which fears the payment will damage GPs' relationships with their patients by incentivising them to slash costs.

When pressed on whether they could rule out paying for the quality premium from existing GMS and PMS funding, a DH spokesperson said: ‘We will publish more information as soon as possible, but it is important we get the details right. This means we now expect to be publishing more information in the New Year.'

Dr Simon Poole, deputy chair of the GPC's commissioning and service development subcommittee and a GP in Histon, Cambridgeshire, said it would be ‘completely unacceptable' if the Government tried to fund the payment from GMS or PMS income.

He said: ‘It would be completely unacceptable for it come out of core funding. We're very clear that it shouldn't be used as a blunt instrument to reward practices or GPs for reducing referrals, prescribing costs or coming in under budget.'

‘The quality premium is an example of where the risk of undermining trust occurs most obviously in the health bill.'

READERS' COMMENTS

Malcolm Ridgway, GP Partner,
20 Dec 2011
If the quality premium was brought in in this way I think the trickle of GPs leaving commissioning would rapidly become a flood. It is already a poisoned chalice in many ways and GPs are taking it on at the most challenging time the NHS has ever faced. Lansley will definitiely have to get this bit right if he is to keep the hearts and minds of GPs.
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