Enhanced services funds diverted

Local health boards diverted more than half of a £6.5 million uplift for enhanced services in Wales in 2008/9 to other services, GPC Wales says.

Dr Bailey: local health boards are diverting enahnced services cash
Dr Bailey: local health boards are diverting enahnced services cash

Speaking at the 2010 Welsh LMCs Conference in Llandudno, GPC Wales chairman Dr David Bailey said that just £2.5 million of the cash was spent on extending enhanced services.

The comments came as GPC Wales released a document pointing to enhanced services as a factor keeping Welsh practice profits below those in England. Enhanced services account for 9.6 per cent of GMS spending in England, but just 7.4 per cent in Wales, the paper reveals.

LMC representatives suggested enhanced services cash had been used to subsidise services such as out-of-hours care or transporting test samples.

Representatives unanimously voted for the Welsh government to investigate local health boards' (LHBs) enhanced services spending.

But Dr Bailey warned there was 'little commitment' from the government to address the situation.

He said: 'The LHBs' actions on enhanced services in Wales have not exactly increased the confidence of GPs.

'LHBs are arguing that the money has still been spent within the overall primary care budget, but ministers were clear that the money should be used for enhanced services.'

Dr David Grant, a member of Gwent LMC, also voiced concerns that the 'basket' of five directed enhanced services (DESs) for Wales had 'failed in many areas'.

He said what should have been a more sensible way of focusing services had become a way of controlling costs, as many LHBs chose only to invest in one DES from the basket.

He said: 'Many LHBs are hiding behind the lack of funding as the reason why they haven't invested more extensively from the basket.'

GPC Wales guidance on tackling falling profits said GPs could 'work harder' by increasing consultations per doctor, reduce workload by reducing consultations and/or access, cut staff or use less use less expensive staff than doctors for some consultations.

Dr Bailey said the options were 'unpalatable', but the only way to boost profits barring an enhanced services uplift.

NHS Fees and Allowances - Enhanced services

GMS pay award 2009/10 - Global sum

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