Once again the DoH reveals its ignorance

A payment of 2.8p per registered patient may seem a footling amount in the greater scheme of practice finances, but the debacle over choice surveys has wider implications within the use of enhanced service targets for political ends.

The payment is an administration fee to cover the distribution of surveys for the choice and booking directed enhanced service (DES) in England, but it will only be paid out if 1.5 per cent of a practice's patients returned the survey. In Brighton and Hove City PCT no practice has achieved this.

In choosing this threshold, the DoH has once again revealed its monumental ignorance of the workings of general practice. To qualify for the payment, GPs would have had to refer a minimum of 1.5 per cent of their practice population during the survey period - a figure GPs agree is on the high side. And if they are in a practice striving to meet another government target, that of reducing referrals, issuing enough surveys would be impossible.

That is before you consider the patient factor. To achieve the target, practices would require every patient referred to complete and return the survey. This return rate would be regarded as fantastical by any market research company, and that is before you target a population who are ill, in pain and contemplating a hospital visit.

In other words, the DoH has set GPs a task similar to those set for the heroes of Greek myths and fairy stories. It seems designed for failure.

The Choice DES has always been a double-edged sword for GPs. Achieve it and it is the DoH not GPs who come out shining, fail and the government can accuse GPs of disregarding patient wishes. Now it might provide an extra statistic suggesting GPs did not care enough to hand out the surveys.

DoH surveys and accumulating a few pence per patient here and there through DESs on government priorities have little to do with the job of general practice, and it might waste time and resources. The DoH should allow GPs to do their jobs, rather than expect them to act as glorified data clerks.

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