Call me a paranoid catastrophist, but I reckon there could be a connection between two recent news stories – one on case management à la Unplanned Admissions DES and the other involving Jezza getting tough on hospital seven-day working.
So. The first one. Who’d a thunk it – producing care plans doesn’t seem to reduce mortality, admissions or costs? But it does improve, by just a teensy, weensy bit, patient satisfaction. Which you or I could have told the researchers, given that we all know this exercise in futility succeeds only in eroding our time/souls while generating a ripple of positive feedback from punters who like the idea of us, er, ‘caring’.
Now, if I was a politician, this would make me think that all that funding we’re ploughing into the Unplanned Admissions DES is starting to sound like a waste of money. On the other hand, it’s a cool PR exercise, so if only we could get those pesky GPs to do it for free… Oh yeah, we can. We just make it a contractual obligation.
Which leaves a whole heap of ex-QOF/new DES money to be re-earned in some other way. And that leads us to the second story. Because you can bet that, after hospital doctors, we GPs will be next in line for some aggressive negotiating, aka an imposed contract, to achieve a seven-day service. And the funding for this will come from…ah, you’re ahead of me. Twice recycled money which will be trumpeted as carrot rather than stick.
Yes, this does sound a bit like psychotic pessimism, but when you’ve repeatedly been on the receiving end of malevolent governmental sleight-of-hand, it’s the only rational response. So if you’re not a paranoid catastrophist, too, you must be mad. Or working for them.
Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield
