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GP payment for providing continuity of care 'being considered by ministers'

Exclusive GPs could be given cash incentives to ensure they provide patients with continuity of care for 60% of the time, under plans being considered by NHS England.

The Family Doctor Association has pitched that a ‘continuity of care allowance’ should be offered to GPs by the Government, in a bid to financially incentivise continuity in practices.

FDA chair Dr Peter Swinyard said that Ben Dyson, director at NHS England and health minister Earl Howe were ‘very interested’ in the proposals that he claimed will lead to ‘improved patient satisfaction and reduced secondary care costs’.

The proposal follows evidence that patients who establish longer relationships with GPs are less likely to require outpatient hospital treatment and that boosting continuity by 1% could save £20k per GP practice over one year.

Dr Swinyard said the scheme could be monitored through the clinical computer systems already in place in practices across England. A simple search query would be able to pull out the records of whether patients in a practice have seen the same GP at least 60% of the time within a given year.

Dr Swinyard suggested that a pilot of the scheme would be ‘quite simple.’ Computer queries in practices could be compared against secondary costs in a defined area, ‘for at least a year’, to map whether improved continuity has decreased patient’s use of services in hospitals.

He said: ‘This is such a straightforward idea but it could be one that is really good for patients and really good for practice.’

He argued that the 60% target is where‘research shows’ the tipping point between good and poor continuity of care.

He said: ‘It allows for the fact that sometimes patients want the quickest, not the best doctor, or that doctors may be on training or holiday leave.’

But the move comes as NHS England suggests GPs should provide more appointments in the evening and at weekends, under its suggestions on how to address ‘growing dissatisfaction’ with access to practices put out for consultation last month.

Dr Beth McCarron-Nash, GPC negotiator, said: ‘There needs to be a balance between convenience of access and continuity of care. What we need is core funding – so we can actually deliver our services. This needs to be considered very carefully.’

An NHS England spokesman said: ‘We have no current plans for a continuity of care allowance. We are, however, very keen to explore a range of ways to support general practice in providing more personalised, proactive care, particularly for patients with more complex health needs.’

Readers' comments (19)

  • Probably to be know as the "part time tax"

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  • How does this idea work in relation to patients coming to see the practice's GPs with special interests? A lady coming for HRT, a diabetes review, a cortisone joint injection and a minor op will have seen 4 different GPs at this practice and received the best care we can offer as a result.

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  • Despite being "Full time+" I have total sympathy with Gavin Jamie comment.
    Beth Cameron Nash is spot on- the most important issue facing us all is adequate remuneration for our time on task.
    You can bet if the politicians are looking at "continuity of care issues" - a concept they did not rate and declined to remunerate in 2004 contract OOH split, then have actively briefed against for two decades (" it does not matter who I see just as long as it is timely"),
    the only possible interest they have in the concept is to increase disharmony within the profession.

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  • You cannot have continuity AND access both of which seem to be on the agenda to promise the unsuspecting public UNLESS there is an excess of resources in the system i.e. too many docs. In addition those docs have to educate to reduce demand very actively.

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  • If they are looking at saving £2,000 per practice, then the payment is likely to be less than that. Easy to say no as it is not worth the hassle factor.

    My time and family life is worth more to me. Just shows how little they value our time.

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  • Micromanagement from the centre yet again! Can think of lots of unintended consequences of this stupidity, but thankfully am retiring next year - I feel so sorry for those left behind!

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  • amanda lindsay don't worry about those who are left behind, most of us are:
    a) working as a sessional dr because we can't get a partnership anyway and have now discovered its less stress and less hassle anyway
    b) leaving general practice by either retiring or becoming a locum and picking and choosing what we do
    b) leaving for the antipodes
    c) thinking of following our fellow dentist colleagues and setting up private practice
    ?any other suggestions on how to tell the government to shove their contract where the sun don't shine

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  • So, my partner with interest in psychiatry and personality disorder will have to sacrify her holiday, family life and everything else, whilst university practice with low number of recurrent attender do.quite well.

    yes, that will really work.

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  • It might give the small practices a boost - where we seem to loose out on everything else that requires massive manpower. I cannot find a replacement partner - nobody is interested.

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  • Wholeheartedly agree with Stephen MCcarthy's comment - promising patients access to GPs at all times to suit AND continuity of care to frail and vulnerable patients who value an ongoing relationship with their own GP is unrealistic even with unlimited money and resources which are unlikely to be forthcoming (assuming we are all still allowed some time off to sleep/eat/have a holiday/shower/fulfil our family obligations etc?). I cannot understand why there doesn't seem to be a wider understanding of these issues in the general population, that GPs are being expected to do more and more for less in the context of massively increasing expectation and an aging population. Probably because lazy journalism sells more papers.

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