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Postcode lottery fear on scaled down GP enhanced services

LMCs are warning a postcode lottery will develop if GPs bow to primary care organisation pressure to agree scaled-down national enhanc-ed services paying less money.

PCOs in some areas are looking to strike deals for GPs to provide services such as

minor surgery, drug misuse, sexual health and warfarin monitoring for less than the benchmark national rates.

GPs in Avon have agreed to offer lower specification services for less money because trusts in the region are coping with massive acute trust debts.

But LMCs in several areas are 'bombarding' practices with reminders not to give in to PCO pressure.

Sheffield LMC said one of the four PCOs it covers wanted to develop a local enhanced service for warfarin monitoring whereas the other three were following the national specification.

Sheffield LMC secretary Dr John Russell said agreeing to the move would create a postcode lottery.

'We would like to see PCOs honour the national enhanced services and not rebadge them as local enhanced services,' he said. 'It is important we don't have that as it would create differences between GPs.'

Secretary of Essex LMC Dr Brian Balmer said diluting the national enhanced service specifications was 'the road to ruin'. There were implications for patient safety if services were provided 'on the cheap', he added.

'Someone will come up with a medicolegal problem. Minor surgery springs to mind as something you don't tamper with,' he said.

Dr Balmer said 80 per cent of Essex practices were refusing to compromise on enhanced services, but trusts were 'trying to pick them off one by one'.

Dr Chris Tiarks, chair of Berkshire and Buckingham-shire LMC, said some PCOs had tried to tamper with enhanced services specifications.

By Craig Kenny

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