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NI GPs to lose income protection if they don’t staff Covid centres


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GPs in Northern Ireland have been told they will lose their protected payments from QOF and enhanced services unless they staff Covid centres.

This is the latest update on the long-running disagreement regarding the centres,which have been set up across Northern Ireland to assess patients with coronavirus symptoms.

Northern Ireland’s Health and Social Care Board (HSCB) told Pulse that only five practices have declined to participate in staffing the centres.

Anonymous GPs from these practices have claimed they have legitimate reasons why they are not able to take part, including distance, staff pressure and health reasons.

They were previously threatened with contractual imposition in April and received further pressure to sign up in August.

Now they have been told that they need to resume QOF reporting and enhanced services in order to secure related payments.

Although these payments were given protected status by the NI Government at the start of the pandemic, a letter from the HSCB to practices sent 2 December said that ‘in standing down these elements of the contract, practices were required to fully engage and commit to the Covid centres to help manage the crisis’.

It added: ‘Non-participation in the rota for Covid-19 Centres will mean that your practices will be expected to meet QOF targets and QOF payment for 2020/21 will be based on upon actual achievement as per the Standard of Financial Entitlement (SFE).

‘Enhanced Services will be paid based upon actual practice activity carried out to the terms of the relevant service specification.’

The letter, signed by HSCB head of general medical services Dr Margaret O’Brien, stressed that the Covid centres had ‘been an instrumental part of general practice’s response to the pandemic’.

She told GPs: ‘Whilst the majority of practices have contributed to these centres a small number including your own have decided not to participate in the operation of the Centres.

‘I would urge you once again to reconsider your decision in this regard. I would be grateful if you could complete the return attached to notify HCSB of your intentions going forward.’

But a GP who received the letter, based just outside Belfast, told Pulse: ‘Being a single-handed GP, I can’t be in two places at one time – the door would have been shut for my patients.’

Another GP, based in a rural practice and who wished to remain anonymous, said: ‘Obliging some practices at this late stage to engage with QOF etc increases risk for patients and practices. Having to bring in COPD patients for QOF purposes is just not acceptable in the midst of a pandemic, for example. 

They added: ‘Adding to workload and stress at this time is irresponsible and this letter ought to be withdrawn immediately.’

The GP also said that they wished the BMA would ‘respond to the letters being issued’.

‘They have previously stated that they would support practices who opt to care for their own Covid and suspected Covid patients,’ they said.

The GP further suggested it was ‘petty’ by the NI Government to claw back the QOF and enhanced services payments from a small number of practices.

However, an HSCB spokesperson told Pulse: ‘Only five GP practices across Northern Ireland have chosen not to take part in supporting Covid Centres during the pandemic.

‘It is clear from the agreement between the Department of Health, the HSCB and the NI General Practice committee that easements against elements of the regular GP contract were to acknowledge the GP contribution to Covid centres.

‘It is therefore appropriate that GPs who do not wish to be part of the GP Covid centre response should continue to meet their targets under the regular GP contract, and this includes meeting QOF activity and reporting.’

BMA NI GP committee chair Dr Alan Stout said: ‘We have ensured that any Covid centre work is non-contractual and that practices have the full choice in whether or not to avail of the agreement we have reached with the Department of Health on this area of work.’

According to the HSCB, Covid centres are staffed by GPs, nurses and other support staff to treat patients who have tested positive for or are suspected of having Covid-19 in the community.  Patients have to be referred to these centres by their own GP or by GP Out of Hours.

READERS' COMMENTS [8]

Mark Cathcart 16 December, 2020 9:38 am

This is so very wrong, to bully coerce and threaten doctors in the midst of a global pandemic is wrong
The covid centres are non contractual and if non participating practices can’t or won’t do this work then they must not be punished for declining to do non contractual work
Alan Stout and Tom Black as our BMA leaders need to step in and protect these practices before they collapse due to mean spirited DoH funding withdrawal
If these practices fail due to funding cuts, what arrangements do DOH have in place to look after their patients when we have a province wide Gp workforce crisis?
Come on BMA, do your job and protect your doctors

Anonymous 16 December, 2020 10:19 am

I don’t know where this quote from Alan Stout came from but at the beginning of this when he, the doh and the rcgp set up the covid centres he phoned me personally to tell me that we had no choice and we must work in these covid centres
After some campaigning we managed to get out of having to populate the ooh element of this new very expensive and in many doctors’ opinions unnecessary service
Janine O’Kane

John Glenn 16 December, 2020 11:15 am

It was never sold as a choice at all or I suspect many would have chosen to run with qof. It was an imposition

Turn out The lights 16 December, 2020 11:24 am

Not a good advert for working in NI.

john mccormack 16 December, 2020 1:32 pm

Appalling and almost certainly illegal from DOH. The BMA/RCGP need to seriously up their game to protect our colleagues who undoubtedly have very good reasons for not participating in covid centres.

John McSparran 16 December, 2020 3:19 pm

BMA and RCGP were instrumental in designing this and supporting its imposition on GPs.

An arbitrary decision was taken that each practice would be allocated a number of shifts based on practice lists. This was not negotiable and took no cognisance of whether a practice was single-handed, had someone on maternity leave or doctor in the at risk category, among other issues.

Only a couple of months later after much pressure on politicians and DoH, did it emerge that this initiative was not contractual. At a subsequent meeting, BMA stated that they would support those practices not participating. Now it is clear that they have no intention of doing so. This is an outrageous betrayal of GPs and the question of whether the BMA really is acting on behalf of its membership now needs to be asked.

Patrufini Duffy 17 December, 2020 12:58 pm

Absolute shocker. Employer harassment.

David Church 18 December, 2020 10:18 pm

Is this policy Racist?