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It must be GP funding negotiation time.

Community Veteran
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Registered: 21-03-2011

It must be GP funding negotiation time.

Here we go again. The GPs who's funding has massively increased over the past few years, are demanding more investment. A BBC report shows the latest demands by their Royal College. These are the same people who were given control of local funding by Andrew Lansley and the same people who have led the drive to close nurse led Walk-In-Centres around the country. It is just the risk they face as the Principals of  private partnerships.
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8 REPLIES
Community Veteran
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Registered: 12-08-2007

Re: It must be GP funding negotiation time.

GPs are taking on more work that would once have been done by consultants in hospitals. This has to be funded. The overall health budget remains the same with finances simply following the service.
Community Veteran
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Registered: 21-03-2011

Re: It must be GP funding negotiation time.

@artmo these same (collective) GPs have absorbed the funding which used to go to Walk-In-Centres and thus already have increased funding collectively. It would be interesting to know exactly what the extra work which would have been done by the (increased) number of consultants. No, the GPs are private business people who've had substantial increases in fees plus additional service payments and have chosen to accept increased take home pay while cutting their out of hours load.,  The fee structure is based on the number of patients so are they saying individual patients are visiting more frequently?
Their actual hours of work should be better tracked if they are demanding yet more pay. You'll find many GPs actually only work part weeks.
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itsme
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Registered: 07-04-2007

Re: It must be GP funding negotiation time.

Quote from: artmo
GPs are taking on more work that would once have been done by consultants in hospitals.

Didn't see any mention of that in the report. They are complaining about the number of consultations and the extra admin. My experience of the practise I'm with and others that family members are with is that they are not to serve the patient but to meet government targets. Try to get an appointment in a week or two time and you are normally meet with you have to ring on the day, so this has the affect that you don't bother seeing a GP to look at minor issue or have other things checked like the prostrate.  
alanf
Aspiring Pro
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Registered: 17-10-2007

Re: It must be GP funding negotiation time.

If GPs take on work otherwise done in hospitals, such as minor surgery, they get paid extra for it.
When GPs fail to provide appointments patients turn up at A&E and are treated there instead of by the GP. 
Work in practices is increasingly done by highly qualified nurses instead of doctors.
I didn't think that the problem was lack of money but lack of GPs. Yet a few years ago it was reported that medical schools had trained TOO MANY doctors and that many would have to go abroad to find jobs!
"While general practice deals with 90% of patient contact, it only receives 8.39% of the overall NHS budget, the RCGP said." What a meaningless statistic. The overall NHS budget pays for expensive drugs, MRI scanners, food (such as it is) for patients during lengthy stays on a ward etc. etc. GPs don't have these costs so why should they have any bearing on the amount paid to GPs? It may be the case that it would be cheaper and more convenient if a GP provided certain services than a hospital but I thought that GPs were claiming they were overworked already!
Community Veteran
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Registered: 27-10-2012

Re: It must be GP funding negotiation time.

What a lot of larger practices are doing now is running clinics that would normally be run at a hospital. To do this, they employ consultants and specialists to run the clinics. These are generally more efficiently run clinics (shorter waiting times/better service) and result in substantial cost savings for the NHS (you would be shocked to hear what some consultants charge the NHS for an hour's work, when quite often a non-doctor specialist can do the same work for a fraction of the cost).
The Government made a huge mistake a number of years ago by introducing QOFs (Quality and Outcomes Framework) for GP Practices. These were essentially targets in various areas that if met, would result in extra payments to GP Practices. The targets were far too easy for GPs to meet and the Government tried to backtrack on them, but unsuccessfully as they were written into the GP Practice contracts.
Now we have the CCGs deciding what money goes where for healthcare spending. Unfortunately, there are just too many conflicts of interest with the CCGs and some of them are corrupt. You have GPs who are members of CCGs that awarding contracts to provide certain community services to either private companies they are involved in, or even their own GP Practices.
Community Veteran
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Registered: 12-08-2007

Re: It must be GP funding negotiation time.

There are good and bad CCGs but I am not aware of any that are corrupt.
A criticism of the PCTs was that they were staffed by bureaucrats with no medical knowledge and when the CCGs were formed it was deliberately with medical people on the board. This was a good move.
Conflicts of interest should not exist as CCGs have a duty to deal with this when offering contracts.  It may be that a contract for services is given to an organisation where GPs have an interest but this would be after due diligence has been undertaken.
Community Veteran
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Registered: 27-10-2012

Re: It must be GP funding negotiation time.

I should say that I am from a family of GPs and one family member now works with a number of CCGs on tendering for contracts - some of the emails that get circulated from CCG members are quite scary.
One of the problems is that even though CCG members (with a vested interest in a service that is being tendered) remove themselves from the decision making process, that does not stop them from sending emails and circulating their own views to other members.
The other that I have seen is where a CCG member is a friend or colleague of someone providing an existing service that essentially going to be taken over by someone else.
Community Veteran
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Registered: 12-08-2007

Re: It must be GP funding negotiation time.

I should say I sit on a number of health committees. We are very conscious of conflict of interest issues. I have a CCG Board on Thursday. Prior to this meeting I will be attending a meeting on Wednesday to discuss a conflict of interest issue to decide on a recommendation to the board meeting.
When deciding on contracts most GPs will be aware of other GPs interests. They all have an equal right to tender and the process has to be seen to be fair. A company tendering will have to declare details of their company including any GPs who serve as directors.