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LMCs vote down proposals for GP payment by patient contacts

LMCs from across the UK have voted down a proposal for bringing in charges for the number of patient contacts alongside list size after it was suggested the controversial measure would encourage ’quantity over quality.’

Delegates at the LMCs Conference in Belfast heard today that radical change was needed to better support GPs as payment made through the contract does not reflect the number of times a patient visits a practice. 

However, following a heated debate, the motion was voted down by the majority of GPs. 

Proposing the motion, Dr Thomas Kinloch from Mid Mersey LMC said: ’Our contract is a complicated beast. Although the global sum is paid monthly, its value is only adjusted quarterly based on the number of patients registered at the start of the quarter. Patients who registered after the start of the quarter and leave before the end of the quarter are not attracting payment.

’That’s supposed to be fine because the global sum is supposed to average itself out: payments for patients who join during the quarter balance payments for patients who leave and payment for patients who see us daily are balanced by payments for patients who see us rarely. However, some patients have far more than average needs.

He added: ’Patients at end of life require the most intense and personal input. It’s fundamentally unfair on an overstretched GP workforce to expect such patients, who are righty at no fault of their own, to be managed without adequate resources. A system which resources practices for patients who both register and die in the same quarter perhaps through quarters global sum payment would surely support both practices and patients.’

Opposing the motion, Dr Remi Eliad from Hertfordshire LMC said: ’The payment per contact will encourage repeat attendances […] and arrangements for reviews and repeat rather than encouraging holistic and robust management plans.

’This approach of counting numbers will result in resources going towards quantity rather than quality.’

LMCs voted against the first part of the motion but supported the second part. 

Motion in full 

That conference demands that payments in any GP contract should:

(i) reflect numbers of patient contacts undertaken as well as size list – LOST

(ii) ensure that ractices receive payment for registered patients who die before the end of a quarter – PASSED