DoH model 'underestimates cost of vascular screening'

Economic report on screening plans branded as 'nonsense'.

The DoH's first model of national cardiovascular disease (CVD) screening hugely underestimates the workload and cost of the scheme, say experts.

The report, 'Economic Modelling for Vascular Checks', says 3 million vascular checks will require 10 minutes' work per GP per week at first, rising to just under an hour after six years.

Dr Graham Archard, a GP with an interest in CVD, described the figures as 'nonsense' and said the DoH estimate would not cover the initial check.

Dr Archard, who has been performing vascular screening at his practice for 20 years, said: 'I am in favour of this but to suggest it will take an hour a week is absolute nonsense. It's a lot more complicated than the government is pretending. It must be properly resourced.'

GPC deputy chairman Dr Richard Vautrey said PCT managers were already concerned that it would not be possible to do within the £243 million annual budget set aside by the DoH for vascular screening.

The model also relies on an extra hour of work per week from each healthcare assistant and administrator in England - plus an hour and a half from each practice nurse.

The average GP practice would perform 250 vascular assessments a year, the report says. The numbers are way below the BMA's estimate of 40 extra appointments per week, but Dr Vautrey said most patients would want to discuss their risk factors with their GP.

'It underestimates that it is a very complicated thing to describe a set of risk factors to a patient. There will be an increased desire to discuss these with their GP,' he said.

The DoH's report states: 'While this is not an insignificant addition to the practice staff's workload, it is also not so large as to require significant disruption to current provision of services.'

The DoH estimates that each check will cost £23.70, including staff and lab costs, but it is still unclear how practices will be paid.

Dr Vautrey said PCTs were looking at local enhanced services to compensate PCTs for the work, which he welcomed, but said there had been 'no discussion at all' between the DoH and the GPC about payment.

Primary Care Cardiovascular Society chairman Dr Terry McCormack said the screening programme was a 'mass-scale experiment' that may be reassessed if the funding turns out to be insufficient.

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