Call for national list of NHS services to avoid conflict

The government must produce a national list of services available on the NHS to avoid GP conflicts of interest over private work, say GP leaders.

Dr Vautrey: ‘The government is not brave enough to say there is a limit to what the NHS can offer.'
Dr Vautrey: ‘The government is not brave enough to say there is a limit to what the NHS can offer.'

A national list would help GPs avoid conflicts of interest which could arise when providing services to local CCGs.

The call comes after a York-based practice was criticised for writing to its patients offering them a range of minor treatments privately, explaining that they were not funded by the local NHS.

Under current regulations GPs can provide private healthcare to patients that are not registered with them. They can also charge their own patients for a limited number of non-medical services, such as completing insurance certificates.

Once PCTs are abolished, deciding which services are and are not available should not be left to CCGs, GPC negotiator Dr Richard Vautrey said.

If they are forced to make such decisions, problems could arise, for example if GPs, who are members of the CCG, privately offered services that had been disallowed by the CCG.

Dr Vautrey said the government was ‘passing the buck’ by forcing CCGs to decide which services should be cut and threatened to undermine patient trust.

‘The government is not brave enough to say there is a limit to what the NHS can offer, for example cosmetic services,’ he said.

CCGs need ‘national guidance about what is and isn’t available on the NHS’, to avoid such problems, Dr Vautrey said.

RCGP chairwoman Dr Clare Gerada agreed. She said it is important to make it clear what services GPs should be offering on the NHS, otherwise there is a danger of CCGs deciding piecemeal what services they will offer.

 ‘We need to decide what is available on the NHS,’ she said.

Dr Vautrey said current ‘postcode lotteries’ in care were down to decisions being made at a local level by PCTs.

‘There is an inconsistency of approach that PCTs are taking to define what services are available.’

‘This leaves patients very confused and highlights a need for clear consistency across the country,’ Dr Vautrey said.

GPC negotiator Dr Peter Holden said it is about time that the public and the government are clear that the NHS cannot fund everything.

 ‘What [the NHS] must provide is that which is essential and immediate. Everything beyond that is a luxury,’ he said.

A national list would set clear guidelines, stopping PCTs or CCGs from making detrimental decisions locally such as blanket banning services.

 ‘A PCT can’t say we don’t fund IVF but it could say we will only fund IVF if they are under 38 with a low body mass index, for example,’ Dr Holden said.

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