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Gold, incentives and meh

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)

  • Whow a practice payment that can't be mined by the large financially orientated practices. The BMA won't agree to that.

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  • Am I the only person concerned about what is going on here? From the comments made this is a very contentious issue and will fundamentally affect the future of general practice. But the proposal is being made and apparently discussed at a high level by the FDA, which is not accountable and not representative of the profession as a whole. There is a real risk of divide and rule, this organisation has already showed its contempt for most GP's by attending 10 Downing Street at the launch of the health and social care bill after the BMA and RCGP had been sidelined by the government. We cannot allow closed door meetings like this to determine our future.

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  • "Mrs Smith wants a visit -she's chesty again."

    "I'll see her then."

    "But if you do then Dr Jones will have see her less than 60% of the time and we won't be paid."

    "Well wait until Dr Jones get back off holiday next week."

    "What if she dies?"

    "That's OK - Dr Jones will still have seen her 63% of the time - we'll be quids in!"

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  • Simple answer - get paid per item billed, works in oz, I was a partner in the uk, on a good wage, left it all as foresaw the issues - capitation is killing uk general practice. Get the money for the work you do. That way those who are lazy or part-time get paid less than fulltime - continuity will result. Best decision ever to leave! And I was LMC, CCG member too.....

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  • Vinci Ho

    Interesting arguments.
    What is the continuity score for single handed GP ?
    Bear in mind , they are to 'fade out' according to RCGP chair.........

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  • And what stupid hoops would we have to jump through and how many boxes would we have to tick to prove that we were doing this.

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  • Do we really need cash incentives to provide good quality care?

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  • 60% of the time - does this mean working (being available) for 101 hours a week? I doubt that will be safe or humanly possible.

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