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GP practices will be paid £60 per home visit for out-of-area patients from January

GP practices will be paid £60 per home visit to patients registered with an out-of-area practice under the new GP choice scheme being rolled out in January, service specifications released today have revealed.

The specifications for the new enhanced service also said that GPs will be paid £16 for conducting a appointments in practice with a patient registered elsewhere, which is more than had been previously expected, after Pulse revealed that one area team had arrangements in place to pay £40 for home visits and £11 for emergency appointments.

In separate guidance on the GP choice scheme unveiled by NHS England today it also revealed that in order to pay for the provision of local care to these patients it may have to reduce payments to the GP practices that are registering out of catchment area patients without the responsibility for home visits.

NHS England admitted that it only expected 0.4% of the population to use the new patient choice scheme, which allows them to register out of their area, including registering with practices closer to their work.

The details of this new enhanced service come after NHS England was forced to delay the scheme from 1 October this year to 5 January, following concerns raised by the GPC that practices had not been given enough time to prepare.

Under the terms of the enhanced services, practices who decide to provide home visits and emergency appointments to patients registered elsewhere should ‘provide urgent and local care’ for patients who fall ill in-hours, who are recovering at home after a period of hospitalisation and home visits.

It also says that there will be a review of any patients who need to be consulted locally at least four times, or have more than two home visits, in a 12-month period to see whether they should be registered closer to home.

NHS England said it is ‘considering whether there should be a small reduction’ in order to ‘off-set the additional costs in meeting their urgent care needs when at home’. It said it will review data from the first six months of implementation to establish the cost of this and then negotiate with the GPC.

It also intends for patients to be directed to the correct urgent care service via NHS 111, which would be informed by the area team which GP practices or walk-in centres are available.

The GPC has warned that area teams and GP practices will find it difficult to plan for the enhanced service because nobody knows exactly how many patients will register with a practice away from their home.

However, NHS England’s guidance said it was expecting that this could be around 200,000 patients in all of England, or 0.4% of the population, based on the uptake in the pilots. These ‘have been typically younger, in work and without complex health problems’, it added.

It said: ‘If this remains the case through national roll-out then the demand for clinically necessary home visits is likely to be low. However, this will need to be kept under review as a growing numbers of patients choose to register out of area without home visits.’

NHS England said ‘most’ pilot patients were also registering with a relatively local practice but lived outside its catchment area. The guidance said: ‘This group of patients should not, in general, need to access alternative arrangements for urgent in-hours primary medical care on the basis they will seek and be able to attend for routine appointments at their registered practice.’

Pulse revealed in September that service specifications for a new enhanced service were sent to GPs in a ‘pre-emptive’ letter from Hertfordshire and the South Midlands area team, before NHS England announced a delay to the policy.

The service specifications for the new enhanced service stated that practices would be offered £11.90 for every routine appointment or telephone consultation that they conduct for patients registered elsewhere.

Readers' comments (28)

  • very nice, we are struggling to offer appointments and sort out home visits for our own registered patients, and not sure how this will work
    I am alright, NO, thank you ..

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  • So if university students come home for the holidays we can charge NHS England £16 for doing their pill check,brilliant!!

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  • After superAnn and tax it's only £20.

    Thos wil potential get rid of practice boundaries and after a few years practices will be expected to do it for nothing.

    I wish all GPs would turn around and say no and send a clear message to the government.

    Though I know a lot of GPs will just sign up to chase a few pounds and not look at the bigger picture.

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  • So that is valuing the surgery time at £96/hour. Think what solicitors charge.

    I don't think this leaves much profit.

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  • 1. What happens if all practices refused?

    Our area is covered by only 2 practices, I suspect neither will be signing up to do visits for 60 pounds a go.

    2. Does it apply to all patients (all TRs) or just those who are at their own home and registered elsewhere?

    3. Can we ask all 10000 of our patients to register at another surgery, then we can register all the patients from their surgery. Then everyone gets paid 16 pounds per appointment + the GMS baseline? (This one is pretty optimistic),

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  • Food for thought indeed. Maybe this is the beginning of the pay per patient/visit programme - Time will tell.

    An example of things to come- In Melbourne, Oz- one was paid $28 per patient during the day, $68 after 6pm; $80 after 8pm and $128 after 11pm to 6am next morning. This was in 2002-03. I bet the rates are higher today.
    Payments were made by Medicover and the system worked. The downside was reflected in a cartoon in the Vicotria Med Journal - GP at his desk with head buried in papers and a man at the door asking- 'Doc, how do you see 60 patients per hour?'
    The response - 'Next please'
    Having said that, it does seem logical that instead of waiting for the NHSE and our wise politicians driving us insane, we might as well gradually privatize on our own and when we are ready and set to go - just hand back our Contracts. Patients will suffer - but then they are going to suffer anyway because the govt gives a hoot to everything except money in coffers for NHS bosses.

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  • NHS England said it is ‘considering whether there should be a small reduction’ in order to ‘off-set the additional costs in meeting their urgent care needs when at home’.

    Call me cynical but I doubt very much that NHSE is "considering" this at all, it will be already decided. This lunacy will have to be funded and as always it will be at our expense - yet another pay cut folks - I look forward to the BMA/GPC taking its usual robust stance as it looks to protect its members......not!

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  • This is absolutely a ploy to open up the market, destroy our 'monopoly' and provide a platform for alternative private providers to come in.
    The figures are derisory for highly trained professionals dealing with this level of risk, never mind the tax, NI and pension deductions.

    We just had to instruct a specialist medical solicitor to sort out some practice agreements/contracts with the local CCG- they have quoted 290 pounds per hour! As i have said before on this subject, my mower repair man charged me 30 pounds just to collect thing and my plumber charges 100 for an emergency call out.
    How did we ever allow our profession to reach this point?
    Combined with the denigration of our profession in the press and from NHSE it is truly depressing

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  • Normal Lamb yesterday asked for an emergency £1.5 billion top up to the NHS because it's verging on bankruptcy. This register-near-work scheme is just not a priority. NHSE took a real battering from the PAC yesterday. We all just need to sit tight, and not sign up for these potty headline-grabbing schemes. Demanding commuters should not push in the queue for an emergency appt, and we shouldn't be bribed to diagnose dementia. Let's all just refuse en masse.

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  • They should have to pay enough for GP out of hours services to cover these visits in hours.

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