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Independents' Day

Patient survey losses were no unhappy accident

A new study confirms that GPs lost cash mainly because of a deliberately harsh deal struck by ministers, rather than dodgy survey methodology

By Richard Hoey

A new study confirms that GPs lost cash mainly because of a deliberately harsh deal struck by ministers, rather than dodgy survey methodology

It perfectly illustrates the strange, and ever so slightly incestuous, world of general practice.

An evaluation of the GP Patient Survey has just been released by a team of researchers including Professor Martin Roland, who of course was one of the architects of that very same survey.

And the BMJ study, which proclaimed the survey as a ‘reliable and valid' basis for GP payments, was publicised by a press release written by the survey's fiercest critics, the BMA.

Better still, GPC chair Dr Laurence Buckman issued a statement just moments afterwards, and sitting adjacently in my email inbox, which repeated the accusation that low survey response rates could have a ‘significant' and ‘detrimental' impact on practices – something the new study refutes.

So the BMA sent out two separate press releases, moments apart, which were politely picking a fight with each other.

Sometimes BMA chair Dr Hamish Meldrum must wish his organisation did not have its rather troublesome duties as a publisher to add to its many other headaches.

But quite aside from the slightly farcical nature of the study's release, the episode was significant for drawing an admission from Dr Buckman that the GPC had again been bested in negotiations with the Government.

His statement represented a significant shift from his previous position, admitting for the first time that the losses through the patient survey were mainly due to the Government's decision to ‘move the goalposts'.

Now I hate to say I told you so, so I'll just refer you instead to a previous blog here, pointing out that it was the changes to the lower payment thresholds, rather than the dodgy survey methodology, which were the major reason why practices incurred such depressing losses.

Those losses have contributed to around a £1,800 fall in the average practice's overall QOF income, which could not be less welcome in an era of steadily falling profits.

And while the BMA has done its best to right the wrongs of the Government's threshold changes by securing a relaxation of the rules for practices who do well on swine flu vaccination, there is a catch.

Vaccination uptake depends not only on practices, but also on patients, and as the response to the death following HPV vaccination demonstrates, patients don't always behave in the sensible, rational manner we would like.

By Richard Hoey, Pulse editor

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