Poor patient memory costs GPs choice cash

Practices could lose almost £3,000 on average because less than a third of patients referred for elective surgery recall being offered a choice of hospital, DoH data shows.

Since January 2006, GPs have been expected to offer patients a choice of at least four hospitals at the point of referral.  

Under the Choice and Booking directed enhanced service (DES) in England, practices receive achievement pay if 60 per cent of patients referred recall being offered this choice.  

The achievement payment is 48p per patient on the practice list, or £2,828 to an average-sized practice with 5,891 patients.  

But a DoH survey of 79,000 patients carried out in May and June this year found that only 30 per cent remember being offered choice.  

More than 60 per cent of patients remembered being offered a choice in only 14 out of the then 303 PCTs in England.  

The survey shows patients were likely to remember being offered a choice if they were aware of their right to it.  

About half of the 29 per cent of patients who knew that they were entitled to a choice of hospitals, remembered being offered it.  

But only 21 per cent of patients who were not aware of the option in advance remembered being offered a choice.  

The findings are a further blow to the use of patient surveys in the GMS contract, after the GPC last month advised practices in England to consider pulling out of the DES for access because of a dispute over the wording of a patient survey (GP, 27 October).  

GPC negotiator, Dr Richard Vautrey, said the findings were cause for concern for practices hoping to achieve the DES targets. He said the findings bore out the GPC’s worst fears about the unfairness of basing GP pay on patient survey results.  

‘Advertisers will tell you that you have to send out your message several times before anyone retains it,’ he said.  

‘GPs may have offered a choice in the consultation but because patients are being asked about this several weeks later they may not remember.’  

He said most patients chose to go to their local hospital anyway, and were unlikely to remember being offered a choice because they were not interested in it.  

Dr Vautrey called on the DoH to advertise widely about choice and said practices could boost their chances of earning DES achievement pay by informing patients better through posters and message boards.  

Choose and forget  

  • Patient recall of choice is only half DES target on average.  
  • Only 14 PCT areas above DES target.  
  • Practices face average £3,000 loss. 

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