Saturday, 5 January 2013

Doctor Argues GP-Led Centre Benefits From Unfair Funding

Posted on May 27, 2009. Filed under: GP-led health centresNews stories | Tags:  |
A GP has levelled a complaint of ‘unfair competition’ against a GP-led health centre that benefits from enhanced funding and performance rewards.
Derbyshire GP John Ashcroft (pictured) told ‘BMA News’ that the Old Station Surgery where he works received about £95 per patient. He said the surgery was situated in a deprived area of Derbyshire County Primary Care Trust.
As of April, the practice faces competition from the Ilkeston Family Practice and Walk-In Centre, which opened around 500m away at Ilkeston Community Hospital. Dr Ashcroft, who was part of a consortium of GP practices that unsuccessfully bid for the health-centre contract, said the centre would receive at least £120 per patient.
‘Unfair competition’
He said: ‘I am not against competition, far from it. What I am against is unfair competition.’
According to ‘Derbyshire County Invitation to Tender Volume 2 – Ilkeston Finance Model’, seen by ‘BMA News’, the GP-led health centre was to have an average cost per patient of £121.52 plus £12.48 per patient contact.
However, extra payments are on offer for achieving new KPI (key performance indicator) targets, which Dr Ashcroft claimed could boost funding to £160 per patient. KPIs exceed the standards set by the GP contract quality and outcomes framework.
Examples include a 12-minute average consultation time, same-day GP appointments, and seeing 85 per cent of walk-in patients within 30 minutes.
The tender’s finance model cites a guaranteed annual contract value of £574,000 in year one and a separate KPI element of around £191,000.
Funding differences
However, a Derbyshire County PCT spokesperson said the guaranteed income for year one of the contract, which was won by Lancashire-based Integral Healthcare Partnership, was just £450,000 and an extra £79,000 was dependent on achieving KPIs.
Another £237,000 was dependent on the number of patients registered and patient contacts at the walk-in centre. The year one target is for 500 registered patients and 20,400 patient contacts.
In subsequent years, guaranteed income decreases and the proportion of funding dependent on KPIs and patient registrations and contacts increases. The PCT spokesperson said the trust was working with all GP practices to improve understanding of historic differences in funding levels and ensure practices were being paid fairly for the services provided.
Derby and Derbyshire Local Medical Committee secretary John Grenville agreed there were funding differences between GP practices in the region.
But he added it was a bit like ‘comparing apples to oranges’, and there was a lot of work to be done before value-for-money assessments could be done comparing existing GP practices with new Equitable Access in Primary Care Services schemes.

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