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GPs should be paid per 1,000 consultations, says Gerada

GP practices should be paid based on the number of patient consultations rather than the number of registered patients, former RCGP chair Professor Clare Gerada has said.

Professor Gerada, who now advises NHS England on its London primary care strategy, said the current contractual model has failed to recognise the increase in consultation rates and needs to change.

Speaking to Pulse, she said: ‘I think the problem we have got at the moment is that we are paid per patients and I think we should maybe look at a different formula and be paid per consultation – or per thousands of consultations, or paid something that takes into account that the consultation work has doubled in [recent] years.’

‘I think it would be much more honest if we were paid by consultation rates than by numbers on our lists because I think what is going on at the moment is that there is no account being taken whatsoever for the increased consultation rate, which has doubled, and we just can’t keep absorbing all of this work.’

Her suggestion comes after delegates at the LMCs Conference voted against a motion suggesting a move to a payment-by-results system only last week.

But Professor Gerada said the ‘desperate’ times meant the profession has to explore contracting options.

She said: ‘My morning surgery, sometimes I just don’t know where to start. We need to completely re-look at the ways that GPs are remunerated. We need to open up a debate… about whether the way that GPs are contracted is the right way. It has served us well, but things are so desperate now that I think we have got to look at all options.’

Last year, while still in her RCGP role, Professor Gerada caused a debate within the profession with her suggestion that all GPs should become salaried.

The RCGP’s 2022 GP evidence pack published last year claimed GP consultation rates increased from three to six per patient over the last decade.