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We’re not even paid for the work we do do

I fully agree that using 10 year-old demographic data as the basis for policy is clearly flawed.

GPs right to be scared of ghost chasing

In the 12 years I have been at my practice, PCT capitation figures have consistently run 100/150 below the number of patients our clinical system says we have – strange how it's always been that way, but it has real income implications. Multiplied across all practices, it's a lot of patients for whom we are not being paid.

We do not track the number of temporary patients we see under our PMS contract, but I suspect it has increased, and if so we are not being paid for any increased activity.

Patients undoubtedly attend more frequently than they did 12 years ago, and patient numbers are not the only measure of workload. Has anyone done any research on GP activity levels?

Our sense is that we are working a lot harder, which is not now reflected in income.

From David Watson

Practice manager, Mill Hill, north-west London