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Quality premiums - just like the fundholding days?

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The commissioning Big Picture has just become a little clearer. Because the Government’s Department of Let’s Make It Up As We Go Along has just fed us another gobbet of CCG information scribbled, as ever, on the back of an envelope.

Remember those ‘Quality Premium Payments’ which the Government promised to CCGs, provided we GPs negotiate a few minor obstacles, such as reducing healthcare related infections, slashing emergency admissions and pulling the NHS out of its financial Black Hole? The assumption was that CCGs would divvy this up between practices as a little reward for all the blood, sweat and tears expended in saving the health service while trying to avoid getting punched/sued/shafted along the way.

Not so. Apparently, CCGs must spend the money on improving patient services, not lining our pockets. Let’s ignore the obvious irony here, that we’re cutting services to save money to gain quality premiums to…er…improve services. Hopefully it’ll be just like the old fundholding days when ‘improving services’ had a broad definition and, if I recall correctly, included selling woks to punters suffering stir fry-deficiency. So we could use our premium dosh to employ, say, an asthma/COPD nurse to screw every QOF point possible out of patients, sorry, that is, to improve patient care?

Again, not so. The money may well be tied into local improvement programmes involving ‘targeted’ incentive schemes. In other words, we’ll be rewarded for hitting targets by being given more targets to hit.

So, going back to the Big Picture, I can’t decide whether it’s an Escher painting of us trudging around for eternity achieving nothing, or a Hieronymus Bosch vision of Hell. Either way, it doesn’t look good.

Dr Tony Copperfield is a GP in Essex. You can email him at tonycopperfield@hotmail.com and follow him on Twitter @DocCopperfield.

Readers' comments (8)

  • Once again Doc Cop you've hit the nail on the head!

    General practice is the place to be for sex addicts. We all are going to get screwed long and hard!

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  • Franz Kafka couldn't have invented this bollocks

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  • This comment has been removed by the moderator.

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  • Can anyone understand what Julie Srhive is on about? Does anyone care?

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  • In response to Steve - Errrrmmmmm, scratching head to first question. Looks rather a sad scenario of a patient, having undergone a massive heart attack is now being denied onward referral to a heart specialist. Though the 'all in her head' is a bit convoluted. To the second question - hope the lady manages to get a rather dire sounding health problem sorted.

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  • Stop the moaning boys and girls We all knew this was at the very least possible yet No one had the guts to say no BMA action was laughable
    Its left to bloggers like Roy Lilley to teel it as it is
    The Government dont believe in a publically funded health care system but will happily take the credit if CCGs turn it around... If not then back to plan A which will be fragmented health care from a range of private providers NHS doing the tricky stuff around UC and subacute care and some form of insurance backed premium for all to meet spiralling costs.

    Simples!

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  • ..."the big picture..." - How about "The Scream" by Edvard Munch ?!

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  • Can somebody give me an inkling about what Julie Srhive said ... just intrigued!!

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From: Copperfield

Dr Tony Copperfield is a jobbing GP in Essex with more than a few chips on his shoulder