Create a prevalence formula that works

Hindsight is a wonderful thing, so it is fair of the GPC negotiators to say they could not have predicted that ‘specialist practices' with unusual patient populations could have had extreme effects on the prevalence weighting applied to the quality framework.

That said, now that it is clear that the problem — first identified by GP some months ago — is costing practices thousands of pounds, questions do need to be answered about the mechanism that many have regarded as over complicated.  

The problem we have discovered is the disproportionate effect of certain ‘practices’ in reducing payments for others; for example, the inclusion in the framework of a GP service at a care home which specialises in dementia patients, and consequently a mental health prevalence of 35.4 per cent, has left practices with prevalences three times the accepted national average having their points value decreased.  

Another specialised service based in a hospital has had similar effects on the stroke and CHD domains.  

Any debate on changing the prevalence formula must address whether these services should be included in the calculations or indeed the quality framework at all. These are specialist services with very low numbers of patients that bear little resemblance to what we think of as ‘normal practices’.  

If they are to be included, then we must address the question of rounding down practices in the top 5 per cent of the range, just as those in the lowest 5 per cent are rounded up.  

Of course there is a simpler solution. Scrap what most GPs agree is an over-complicated system that does not reflect the real workload of dealing with above-average incidence of certain conditions.  

In other words, apply a simple ratio of practice prevalence against national prevalence and forget rounding, adjusting and square rooting.  

Even the DoH could not object to a prevalence formula that ensures GPs are fairly paid for the work they do.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

GP consultations up 400,000 in first three weeks of 2021 compared with last year

GP consultations up 400,000 in first three weeks of 2021 compared with last year

GPs have delivered around 400,000 more patient consultations in the first three full...

GPs vaccinate thousands of patients against COVID-19 in extraordinary settings

GPs vaccinate thousands of patients against COVID-19 in extraordinary settings

GPonline takes a look at some of the more interesting sites that have played host...

UK COVID-19 vaccination programme tracker

UK COVID-19 vaccination programme tracker

GPs across the UK are playing a leading role in the largest-ever NHS vaccination...

GPs to place orders for COVID-19 vaccine as NHS targets second dose at 12 weeks, says Stevens

GPs to place orders for COVID-19 vaccine as NHS targets second dose at 12 weeks, says Stevens

GP-led vaccination sites will be able to place orders for COVID-19 vaccine supplies...

RCGP and Marie Curie urge GPs to adopt end of life care standards for care homes

RCGP and Marie Curie urge GPs to adopt end of life care standards for care homes

Best practice standards to help GPs improve end of life care in care homes despite...

Thank your team for their inspirational work during the COVID-19 pandemic #myGPteam

Thank your team for their inspirational work during the COVID-19 pandemic #myGPteam

Never has teamwork in general practice been more important than during the COVID-19...