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GPs go forth

A third of GPs intend to refuse all new DESs

Exclusive: A third of GP partners are set to sacrifice almost £15,000 in practice funding by rejecting all four of the new DESs proposed by the Government, a Pulse survey has found.

Some 29% of 229 GPs who responded to Pulse’s survey said they would not take on any of the new DESs - worth £3,600 each - that have been financed from retiring the organisational domain of QOF.

Only 24% of GPs said they planned to take part in the telehealth DES that involves the introduction of remote monitoring of patients and 47% said they intended to opt for the DES that incentivises practices to case-manage patients at risk of hospital admission.

Marginally more said they would take on the dementia case-finding DES (53%) and the DESs to developing online access to GP services (52%).


GP leaders said that they simply do not have enough time to take on new work without sacrificing current services, or taking on new staff.

Dr Rosemary Macrae, a GP in St Helens, Merseyside, said she had objections to carrying out work which may not have value.

She said: ‘The dementia screening? How useful is that going to be? It takes time to do properly. It’s not a simple screening test. I have my doubts about the usefulness of some of the work.’

Dr John Cormack, a GP in Essex, said his practice was already ‘cut to the bone’. He said: ‘I think there is a feeling that GPs are magicians expected to pull services out of a magic hat.’

Dr Tony Grewal, medical director of Londonwide LMCs said GPs were unlikely to want to invest in new staff or premises to allow the practice to take on the new work, as they can’t be certain it’ll remain a reliable income stream in future.

He said: ‘GPs have to think carefully before setting themselves up to do something new because they won’t want to drop it in three years in these fluid times with different policies.

‘Investment in premises, training and staff may be a drain on you because an AQP is coming and they’ll win the service and you’ll have to sack all the staff you’ve just hired.’

A DH spokesperson said: ‘Improving the care patients receive is our priority, as it is for GPs who trained to improve the health of their local communities.The Directed Enhanced Services are designed to encourage practice staff to strive for higher standards of care for their patients - and be rewarded for doing so. We hope every practice will take the opportunity to put better services in place for patients with long-term conditions and dementia.’

They added: ‘Our proposed changes to the contract should help practices manage their workload at the same time as improving the health of their local population.’

Readers' comments (3)

  • To put this in context 66 GPs responded to your survey - how statistically signifcant is this and how does it justify the shock horror headlines. It is a well know fact that 35.2% of all statistics are made up on the spot to justify a poorly researched statement - I'm surprised that you have allowed yourself to fall into this elephant trap

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  • Peter Swinyard

    Mr Anonymous is wrong. Only 97% of generalisations and 35.4% of statistics are incorrect/made-up/at the edge of credibility.
    The point remains though and is serious. The elephant is already in the room, not in a trap, and it is that the government is certain that they can impose 1% (not made up) efficiency savings on general practice. I don't know about you, but in our practice, with already falling profits (take sequential pay cuts of 5%, 5% and 8% in the last 3 years please, Mr Hunt) we look after every penny and there is NO slack to take up. I would LOVE a pay freeze!
    We are now looking seriously at whether we can continue to employ locums at the high rates we are charged for a day when we will become liable for their employer's pension contributions from April - realistically either their rates will have to drop to compensate or we will employ less often as the funds used at present for this by the PCTs will land in the global sum which is of no use at all to an MPIG-dependent practice such as ours. We will not see a penny from it.
    Tough times, tough choices ahead.

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  • I think this is one of the few opportunities where jointly we can take a bit of a stand, and send some kind of signal; by collectively refusing to sign up to these DESs, at least at the rates on offer.

    maybe that is a form of "action" which could be proposed/promoted by GPC....?

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