It is a tough sell to the public to argue GPs should be given money for reducing emergency admissions. The first shots have already been fired by the Daily Mail, which suggested that practices stood to gain £30,000 for meeting certain targets.
Indeed, this £30,000 figure has been floating around the health press for the past six months. There is basis for the calculations – the premium will be worth an estimated £5 per patient and the average practice has 6,000 patients.
But this is simply not correct. As the Government’s commissioning czar Dame Barbara Hakin told Pulse, CCGs will not be able to pass these payments directly to member practices.
The payments must be ploughed back into programmes to improve patient care and the NHS Commissioning Board must be satisfied that it does indeed improve patient care.
These programmes do include incentive schemes for meeting targets in specific areas, such as diabetes care, and potentially more controversially for reducing prescribing and referrals. This is very different to payments being given wholesale to practices.
This could be seen in a negative light, in that practices will have to work harder for this new source of income.
However, it will combat the impression that GPs are being given a ‘bonus’ and could help it pass the ‘Daily Mail’ test. By clarifying the position, Sefton LMC chair Dr Andrew Mimnagh also says the Board has made a positive step.
But there are still concerns with the premium – that it will disadvantage CCGs in deprived areas and that the requirement for financial balance will lead to perverse incentives for commissioners. What impression will patients have if they are aware that their GP is being given additional money to reduce their referrals? These kind of schemes could once again harm public perceptions of the premium.
But at least many GPs will welcome greater clarity on how the system will work as they prepare to take on the commissioning reins in less than three months.
Jaimie Kaffash is senior journalist at