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GPs warn of extra workload from change to phlebotomy contract

GPs in Tower Hamlets have warned their CCG of the risk to GP workload from a proposed change to their phlebotomy contract.

The contract currently works on a fee per item basis, dependent on the number of blood tests carried out by general practice, however proposals have been made to change this to a block contract with a capped budget.

Concerns were raised by Tower Hamlets LMC over what happens when the cap is exceeded, and the pressure it might put on GP workload.

Tower Hamlets LMC chair Dr Jackie Applebee said: ‘The concern is as more and more work is being transferred from hospitals to general practice, especially now with the long-term plan saying that there’s too many people going to outpatients, if those are going to be looked after in general practice.

‘It means that we will be doing more blood tests. So, there are concerns about the direction of travel. GPs are already doing loads of unfunded work, we can’t continue to take more. We’re already struggling to provide appointments as it is.’

The amount of phlebotomy funding the borough receives will depend on the previous year’s activity, which Dr Applebee said was a ‘worry’. 

‘Every year they’re going to look at the activity, so it won’t be the same amount. If activity goes up, the size of the contract will go up. They have promised each year to look retrospectively at it. If it goes down, it is a worry. They will base the amount they are prepared to spend on it on the previous year’s activity. It will go up in line with activity, in a way, but it won’t be so secure,’ said Dr Applebee.

If practices exceed the cap, Dr Applebee says it’s unclear what will happen.

She explained: ‘If the CCG dig their heels in and say, “well, you’ve reached the limit now,” I guess GPs will say, we’re not doing the work. We’ll send patients to the hospital to the phlebotomy clinic but then it’s not great for the patients as they have to travel. It’s not convenient and they have to queue,’ she said. 

However, Dr Applebee said the LMC and CCG are ‘trying to come to a mutual business decision.’

‘Like all CCGs they’ve got to find savings, and that causes tension between the providers and the CCGs,’ she told Pulse.

A spokesperson from Tower Hamlets CCG said: ‘We can confirm there is an open dialogue between the CCG and GPs, and we are currently drafting a contract to summarise our joint agreement.’