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Patient survey deals GPs double pay blow

By Gareth Iacobucci

Exclusive: GP practices are facing losses of thousands of pounds through the patient survey this year because most will not qualify for relaxed thresholds on access indicators and survey scores have slumped since the swine flu outbreak.

The double blow means the average practice is set to lose £4,300 this year compared with 2008, and £1,000 more even than last year, when GPs were hit heavily by the toughening of QOF thresholds on the patient survey.

Department of Health figures released last week showed GPs in England had delivered 3.2 million doses of swine flu vaccine across the priority groups, with an overall uptake of 34%.

Most practices will fall short of the 50.7% uptake they need in at-risk under-65s to qualify for relaxed thresholds on the PE7 and PE8 survey questions, with many GPs now focusing on vaccinating under-fives.

In Scotland, where most health boards have now finished phase one of the vaccination campaign, uptake among at-risk under-65s was just 45.8%.

The urgent need for relaxed access thresholds is underlined by the latest patient survey results, showing falls in GP performance for question PE7, on the proportion of people who could get an appointment in 48 hours, and PE8, on the proportion who could get an advanced appointment.

England's results for April to September last year – covering the first swine flu peak – showed performance on PE7 fell from 84% to 81%, and for PE8 from 76% to 72%.

Performance is measured on a sliding scale from 70-90% and 60-90% respectively, meaning falls of this magnitude would result in practices losing a quarter more than last year.

The proportion of practices exceeding the top 90% threshold on PE7 fell from 36% in 2008/9 to 30% last year, and for PE8 from 20% to 15%.

If final patient survey scores are in line with the results for the first two quarters, the average practice will lose £4,315, compared with £3,295 last year.

If the pattern is reflected across the four devolved nations, GPs would lose about £46m in total from the patient survey in 2010, compared with £35m last year.

Dr Sarah Wright, a GP in Birmingham, one of the UK's biggest swine flu hotspots last summer, said the increased workload had almost certainly hit access to her practice.

‘It was inevitable it would have some impact. It is unfair to be financially penalised when we've been trying our best to accommodate the increased workload,' she said.

Dr Richard Vautrey, GPC deputy chair, said GPs had struggled to meet the swine flu uptake target because the illness had not turned out to be as serious as had been predicted.

‘When the agreements were made, nobody was certain about the severity of swine flu. Predictions in the summer were alarming, but things have quietened down. Patients have not being convinced of the severity of the illness, and vaccination has been slower than expected.'

Dr Vautrey said the GPC would wait to see if the vaccination campaign had had a ‘demonstrable difference' on yearly access scores before deciding whether to seek compensation or relaxed targets for affected practices.

A Department of Health spokesperson said: 'We want to make sure that GPs who vaccinated high numbers of patients are compensated. This is in recognition of the extra work from swine flu vaccinations.

'GPs have done an excellent job in vaccinating one in three (3.2m) at risk patients in phase one of the vaccination programme and they are continuing to protect vulnerable people against swine flu.'

Dr Sarah Wright said the increased workload from swine flu had hit access to her practice

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