The payment method for calling in at-risk patients under the national MMR catch-up programme is overly rigid and remunerates practices poorly for the work involved, LMC leaders have warned.
GPs have been asked to identify and contact at-risk patients who have not yet been immunised following recent outbreaks of measles. Under changes to the 2013 contract, GPs are not supposed to receive any additional payment for immunising the main at-risk 10–16-year-old cohort but NHS England has agreed to pay GP practices £1.50 for each patient they find and call in.
But local GP leaders have said the payment system – which specifies that practices must send patients a letter to qualify for payments – is ‘ridiculous’ and the £1.50 barely covers the costs involved.
Dr Tony Grewal, a GP in West London and a medical director for Londonwide LMCs, told Pulse that Londonwide LMCs was able to establish that email is sufficient despite NHS England’s requirement for a hard copy. However he added, sending text messages would not qualify practices for payment.
He said: ‘It’s ridiculous to put in a requirement that a hard copy is sent to people who have told us their preferred method of communication is email or text.’
He added: ‘If practices have used [SMS text systems] to call in the vulnerable group they’re going to have to send a further, unnecessary letter. And if they do this by post, there will be nothing left of the £1.50 by the time they have done it, which is rather ridiculous.’
Dr Grewal also advised GPs to record details of contact with parents or guardians very carefully.
Dr John Hughes, a GP in Crumpsall and honorary secretary of Manchester LMC, said: ‘The £1.50 they’re saying you receive for sending the letter doesn’t really reflect the work involved in doing the searches and finding the patients and contacting them.’
He added: ‘The specification is overly rigid in insisting this has to be a letter. It isn’t the best way to contact patients and I think GPs should be able to use the normal preferred method for contacting them.
‘One suggestion here has been to invite patients as you would normally and then when they come in you can hand them the letter. Any patients who don’t come in can then be sent letters.’
Dr John Canning, a Middlesborough GP and secetary of Cleveland LMC, told Pulse the GP-led programme would be of limited value in Cleveland, where there is already an ongoing schools programme to immunise vulnerable children and teenagers because of small outbreaks centred on Stockton and Middlesborough.
He said: ‘In practice, there’s no need for the call and recall element – because that’s already being picked up by schools. Doing it is not going to create much income and it’s going to create a lot of costs with all the time searching, printing and posting and all the rest of it.’
He added: ‘The schools programme should work very well, there are very good records with the schools anyway.’