GPC fears funding loss over DES drop-out

Forcing GPs to earn back QOF funding through new directed enhanced services (DESs) risks practices losing thousands of pounds of income and many will opt out of providing the services altogether, the GPC has warned.

The GPC says it has a 'fundamental objection' to introducing enhanced services including dementia case-finding without new funding
The GPC says it has a 'fundamental objection' to introducing enhanced services including dementia case-finding without new funding

The GPC's formal response to a consultation on proposed GP contract changes says it has a 'fundamental objection' to four new DESs that the DH wants to introduce in 2013/14.

The DH's plan would see practices forced to earn back money stripped from the QOF organisational domain by providing four new DESs: for risk profiling and care management, case finding for patients with dementia, remote care monitoring and improving online patient access.

In its response to the DH, the GPC said it rejects the principle of the new DESs because they are being introduced 'without any new funding'.

The committee said practices may be 'ill-equipped' to participate in DESs due to short timeframe to prepare, and may lose funding altogether. But many cannot afford to lose this level of funding at a time of increasing demand on general practice.

The GPC said: 'The rush to establish these new services in a very short timeframe, with little consultation and no negotiation, runs the risk that practices will be ill-equipped to participate and may end up losing out on the funding altogether.'

It added: 'Spreading this resource across four DESs is likely to result in low uptake in England’s overstretched GP practices.'

The GPC argued that the dementia case-finding DES was not evidence-based and 'directly contradicts policy from the National Screening Committee and NICE'.

It also warned about the potential for harm and anxiety from false positives, and the workload impact of the required 30-minute assessments for dementia.

The GPC called on the government to reconsider plans for a remote care monitoring DES, and said any move towards improving online patient access should be phased in to make the transition 'manageable' for practices and safe for patients.

A GPC survey of 8,000 GPs across England found 79% believe the 'significant' extra work from the four DESs would have a 'major negative impact on their patient services, staffing and income'.

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