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GPC urges Government to remove GP commissioning incentives from health bill

By Gareth Iacobucci

The Government must remove 'completely unethical' performance-related payments for GP consortia from the health bill as they could undermine patient trust, the GPC has warned.

In new guidance for shadow consortia on how to ensure transparency and probity, the GPC calls on the Government to scrap the proposal to pay GPs in consortia a 'quality premium' if they perform well financially on the basis that the move would 'threaten GPs role as the advocate for the individual patient'.

The launch of the guidance comes in the week that Pulse revealed how the controversial plans to pay GPs based on their ability to manage commissioning budgets has become a key battleground on the Government's NHS reforms, as its listening exercise on the health and social care bill concludes.

The guidance advises GPs on how to navigate five key areas where potential conflicts of interest could arise, including where commissioning leaders have a financial interest in a provider company. Click here to read the full guidance.

It advises that directors of or GPs with a 'significant financial holding' in private health companies should not be on consortium management boards, and that consortia must keep a register of interests that should be formally refreshed every three months.

The GPC expresses serious concerns about instances where GPs' decisions regarding the care of their patients could influence a financial incentive scheme such as the 'quality premium', claiming 'there must be clear divide between commissioning budget allocated to consortia, and individual practice budgets held by GPs'.

The guidance also covers instances where GPs may refer patients to a provider company in which they have a financial interest, where enhanced services are commissioned that could be provided by member practices, and where LMC officers are also key officials in the consortium.

GPC chair Dr Laurence Buckman, said: 'The trust patients place in their doctor is the cornerstone of general practice and while clinically-led commissioning could bring real benefit to patients we don't want this to be at the expense of that trust.'

'GPs are very concerned about the potential conflicts of interest inherent in the health bill. They are worried that their patients' trust in them may be damaged unless there are transparent processes in place to ensure confidence that commissioning decisions are being made in patients' best interests.'

'We have produced this guidance to help shadow consortia ensure that their workings are transparent and can pass public scrutiny, but we want the Government to remove the proposal to give consortia performance-related bonuses from the health bill.'

'Financially rewarding GPs by directly linking their earnings to their consortium's financial management, particularly when the NHS is under continuing pressure to reduce budgets, is completely unethical.'

'We strongly urge the government to listen to and act upon our concerns.'

Click here to read the full guidance.

Dr Laurence Buckman