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Put your money where my mouth is

It’s been a day of two halves today. Let’s call the first part ‘The morning’. This was spent digesting the service specification for a long-acting reversible contraception contract, which, for reasons too dull to relate, but nothing to do with us, we’ve only just received. I say ‘digesting’. But that’s not strictly accurate, because the contents induced in us responses ranging from a vague, nauseated unease through to projectile vomiting.

I’d left the document’s detail to the partners with more X chromosomes than me. I don’t want to sound like a sexist old dinosaur, even if I am, but LARC-world is very much their domain. I’m happy to dish out leaflets and tick QOF boxes, but I draw the line at anything requiring rubber gloves.

But they’ve assured me that this enhanced service comes with more strings attached than the average Mirena. A whole heap of bizarre targets – involving satisfaction, follow-up and so on – are all set at 100%. The implication is that if you deviate from the contract’s definition of perfection, you won’t get paid. Hence the indigestion.

Ironic, innit? The DH pressurises GPs to promote and deliver LARCs. We’re happy to oblige – after all, any legal means of minimising the casting pool for future series of TOWIE has to be a good thing. Yet we’re presented with a contract so draconian that the only rational response is not to bother – which, I’m told, is what many practices in Essex have already decided.

Petulant? I think not. After all, we’ve already had the unplanned admissions DES, with an official NHS England ‘no leniency’ tagline, and the patient participation DES, which many of us have already come a cropper over after an undotted i or uncrossed t – all in a financial environment where we’re constantly having to cajole, beg or grovel to get paid.

So. ‘The afternoon.’ Better news. Apparently, there’s a ‘transformation fund’ of £852k for Essex that practices can bid for individually or collectively, as long as they knock something together by 30th of this month. Available every year. For the next six years. Blimey. That’s … let’s see … a lot of money.

So is this the same pile of cash as the £5 per patient fund, which was also to help transform services in accordance with local and national priorities yadda yadda and also had to be agreed the day after we heard about it? Nope. That’s available too.

Which means that, on the one hand, it’s getting increasingly difficult and demeaning to get paid for what we’re doing. And, on the other, there’s shedloads of dosh sloshing around in various funds for capricious and disparate projects, so long as you put together a business plan yesterday.

I have a better idea. Why not divert all that money into something less whimsical and more worthwhile? Such as a reasonable pay rise for us GPs? In other words, yes, use the cash to buy our goodwill. The Government would be amazed at how innovative and effective GPs can be. Especially when we’re feeling valued rather than sick.

Dr Tony Copperfield is a GP in Essex. You can follow him on Twitter @DocCopperfield