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Tsar signals tougher heart failure scrutiny

The failure of hospitals to supply discharge information for patients will make practice-based commissioning impossible for GPs.

Problems with the Payment by Results tariff system also mean practices can have no confidence in taking over commissioning from PCTs.

The warnings from GPs and the NHS Alliance came as a blow to the prospects for good take-up of the scheme by GPs.

NHS Alliance research has revealed that discharge information may be missing for

as many as one in eight


More than 80 per cent of PCT professional executive committee chairs questioned by the alliance also said they had received late discharge summaries and this had affected patient care.

Dr Mike Dixon, chair of the NHS Alliance, said GPs would be unable to verify work that hospitals had done and how much it should

cost without proper discharge details. He said a single form that includes both discharge and billing information should replace the existing 'claim and take' system.

'There are people at the centre who think this is a

good system and want GPs

to become more militant about patient safety,' he added.

GPs have also revealed absurdities in the new Payment by Results tariff system used by hospitals to bill PCTs ­ or practices if they take over commissioning ­ for their work.

These included costings for 'invalid code' at £534 and 'planned procedure not carried out' ­ slang for hotel bills ­ at £418. A negative diagnosis for deep vein thrombosis can cost over £3,000 whereas a positive diagnosis with hospital treatment is £1,840.

Technical guidance on practice-based commissioning was due last Friday but has been put back until this week at the earliest.

Absurdities of payment by results

Cost of elective spell/non-elective spell

·S22: Planned procedure not carried out £418/£749

·S31: Admission for unexplained symptoms £744/£1856

·S32: Abnormal findings without diagnosis £430/£1051

·Invalid code entered £534

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