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Case management DES ‘will reduce time available for routine patients’



The Government’s proposed risk profiling and case management DES will result in a reduction of the number of routine appointments available, the GPC has warned.

In its official response to the Government’s contract proposals in England, the BMA said that it ‘does not dispute the clinical advantages of taking a multi-disciplinary approach to monitoring the health of those who are most at risk of unscheduled hospital admissions’.

However, it adds that it was ‘disappointed’ that the Government did not accept the risk profiling proposals devised by the BMA and NHS Employers, which should replace specific sections of the existing quality and productivity QOF domain.

The submission said: ‘Introducing the proposed scheme into the QP domain would mean that the objectives of improving care for vulnerable patients and reducing unscheduled hospital admissions can be tackled together, without increasing pressure on overstretched practice staff.

‘Both Scotland and Wales are introducing risk profiling and care management as part of the QP domain, in both cases replacing A&E indicators, with Scotland also using points from the emergency admissions indicators.’

The Government has not provided evidence that the workload from the scheme will be manageable for practices, the response added.

‘The knock-on effect of your proposals will be a reduction in access for other patients as, whilst GPs are in multidisciplinary meetings, the number of available routine patient appointments will decline,’ it said.