Quality point rewards for self-care schemes

GPs should be paid to promote expert patient self-care through initiatives under a revised quality framework from 2007/8, according to the DoH's primary care czar.

Under the plan, the quality framework could include an indicator from next year to measure how successfully practices enable patients to manage their own conditions.

The primary care White Paper earlier this year committed the DoH to considering incentives for GPs to promote self-care as a priority in GMS contract negotiations.

DoH national clinical director of primary care Dr David Colin-Thome told GP that a clinical quality indicator for self-care could be introduced.

Alternatively patient surveys could include a question on self-care.

Dr Colin-Thome said: 'It could be in the quality framework, and someone might come up with an indicator that could go in the clinical section.

'But it is probably best as a patient survey question - as this is about enablement, it needs the patient to confirm that they have received support for self-care.'

Up to £20,000 of quality pay a year per practice already depends on responses to patient surveys. (GP, 24 February)

GPC chairman Dr Hamish Meldrum did not rule out some form of financial incentive for GPs, but said it had no place in the quality framework.

'To put a contractual requirement on GPs to do self-care seems bonkers when the whole point is that GPs wouldn't be doing it,' he said.

However, Dr Meldrum added: 'There may be some work on developing expert patient groups or enhanced services that could be developed. I'm not shutting out the possibility of resourcing practices in some way. But neither surveys nor the quality framework would be appropriate.'

Dr Colin-Thome said self-care should be a negotiating priority: 'It's a lot better evidence-based than some other stuff healthcare funding is spent on.'

Speaking at a conference last month in London, Dr Colin-Thome said self-care could cut GP visits by up to 69 per cent, and hospital admissions and A&E visits by about 50 per cent.

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