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GPPAQ-ing farce

Where Devon, Cornwall and the Isles of Scilly have gone, will you go too?  You’re probably planning frantic meetings at the moment, considering your own practice’s response to a potential area offer from NHS England. 

It sounds like the best news known to GP-kind.  No more up-titrating those statins, desperately driving down that cholesterol to less than five.  No more off-piste maximal quadruple therapy for the hypertensive whose BP is still 142/92 on home monitoring.  No more exploring whether obese arthritics enjoy cycling, or gardening, or childcare (because they like to be asked). 

There must be more to this.  Of course there is: the agreement is supposedly designed to release us from pointless QOF chasing (though according to a source ‘the work must keep going, it just won’t be monitored’) thereby unleashing on us the new contractual work to reduce admissions and allocate over-75s to named GPs.  Although the detail may vary locally, you’d get your QOF payment for 2012/13, minus 10% to reflect the retirement of last years beleaguered domains, or their transubstantiation into DESs.

I smell a big rat.  It has an innocent doughy eyed face just like Jeremy Hunt.  But it’s also got dirty sharp claws and we’ve no idea quite where it’s been, or where it’s off to next.  Let’s not forget that most of the ‘retired’ QOF points have only been ‘operational’ for 12 months.  Like many new GPs, one year in and they’re already burned out.  So it’s not so much a gift as returning a stolen present.  We’ll all calculate that it’ll suit us financially and then it’ll come, around March time: ‘GPs lighter workload earns them cash bonanza,’ or ‘GPs take bonus payment to stop monitoring the sick.’  The Mail will lead on it, but others will follow. 

Personally, it’s the hours of wasted time I can’t abide.  All that work, the sweat and toil, to be told that actually, just stop what you’ve been doing, you can have what you had last year.  One member of our staff spent hours pouring through 350 hypertensives’ records and ticking boxes to confirm (evidenced by the notes) that lifestyle advice had indeed been given.

2013/14 has been a farcical year, and one where real patient care has suffered.  We’ve been so distracted by targets that there’s barely been time to discover why the patient actually came.  It’s a situation we haven’t liked, one that was imposed upon us, and now one that’s being shelved.  Whichever way you go, Devonwards or otherwise, lets get back to caring for patients, not just what’s on the sphyg.  

Dr Tom Gillham is a GP in Hertfordshire and Specialty Doctor in A&E. You can follow him @tjgillham.