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Pay GPs even if parents decline childhood immunisations, say LMCs

Pay GPs even if parents decline childhood immunisations, say LMCs

GPs should get paid for their work even if parents choose to decline childhood immunisation offers, the England LMC conference has said.

A motion which was passed overwhelmingly in all parts said NHS England and the Government must ‘recognise that patients can make informed decisions’ and that there are ‘difficulties in achieving QOF targets’, especially in ‘areas with high patient turnover and areas with marginalised communities’.

Current QOF targets ‘discriminate’ against practices ‘in inner cities and high levels of deprivation’, the motion said, and GPC should negotiate for a QOF target with ‘a lower threshold for payment’ and which incorporates exception reporting.

Presenting the motion, Dr Emma Radcliffe from Tower Hamlets LMC said it was ‘difficult to understand how targets of 90-95% were conceived as a payment metric’ when they are ‘well above the threshold for herd immunity’.

‘The data shows that few if any practices achieved the 95% target in the last financial year. I think we can label it as near-impossible to achieve. Why was it set so high?’

She also argued that the ‘inability for practices to use any form of exception reporting is completely at odds with the NHS commitment to shared decision-making, informed choice and personalised care’.

‘We all know that a lot more effort and resource has been put into families who choose to decline immunisations. There is absolutely no incentive to put this work in if we are not going to meet even the lower target.

‘This work is therefore funded on goodwill alone.’

No delegate spoke against the motion, except Hertfordshire LMC’s Dr Rami Eliad, who called for it to be taken as a reference because ‘the system is broken’. He said GPs should to be paid for the work they carried out, including DNAs, rather than the achievement against targets.

The Covid pandemic negatively affected vaccine confidence, researchers have found, and no routine childhood vaccination met the 95% uptake target set by the World Health Organization last year in England.

However, a recent Pulse Intelligence analysis showed that practices are benefiting from changes to childhood immunisation payments, but those in the most affluent areas are benefiting most. 

The annual England LMC conference takes place in London today, and is livestreamed.

Motion in full

TOWER HAMLETS: That conference recognises the importance of childhood immunisations and applauds the work that general practices have done in the last year despite many knowing that this work would go unrewarded through QOF payments. Conference demands that:

(i) NHSEI and the government recognise that patients can make informed decisions PASSED

(ii) NHSEI recognise the difficulties in achieving QOF targets, particularly in areas with high patient turnover and areas with marginalised communities thereby discriminating against practices in inner cities and high levels of deprivation PASSED

(iii) GPC England negotiate with NHSEI a QOF target with a lower threshold for payment for childhood immunisations PASSED

(iv) GPC England negotiate with NHSEI that exception reporting should be incorporated into all QOF targets. PASSED

Source: BMA


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Please note, only GPs are permitted to add comments to articles

David Banner 25 November, 2022 8:44 am

The cynical money-saving decision to not allow exception reporting has spectacularly backfired. Once Practices realise they have zero chance of hitting targets before they even begin, there is no incentive to chase down non-attenders, resulting in falling immunisation rates across the country.
We should not be punished if parents’ right to choose is maintained. Exception reporting needs to be robust, with signed declarations from parents, but not allowing it at all is not just hitting GP income, it’s damaging the health of children everywhere.

Slobber Dog 25 November, 2022 11:21 am

Make it a practice policy that all children are fully vaccinated unless there is a medical contra- indication.
Just imagine the consequences of an infected child with M,M or R in a packed waiting room.