Current advice on doctors fees

[Wb123]

According to the latest info, doctors cannot refuse flat, it's their responsibility to find a Doctor who will respond and cannot charge for the initial letter.

My understanding is basc want the charges dropped, but a workable system has not been negotiated yet. The latest statement simply reiterates the requirement for conscientious objectors to direct to another doctor, as was already the case.

 

Given that this work is not funded in the nhs gp contract, and takes time away that otherwise would be income generating, some form of adequate renumeration should be provided for. The starting point for consideration would be a figure from several years ago of needing to generate £200 an hour to cover building, staff, indemnity, and other costs.

[BrowningB525]

My understanding is basc want the charges dropped, but a workable system has not been negotiated yet. The latest statement simply reiterates the requirement for conscientious objectors to direct to another doctor, as was already the case.

 

Given that this work is not funded in the nhs gp contract, and takes time away that otherwise would be income generating, some form of adequate renumeration should be provided for. The starting point for consideration would be a figure from several years ago of needing to generate £200 an hour to cover building, staff, indemnity, and other costs.

 

Are GPs not paid for the number of registered patients? Therefore are not losing revenue replying to licence applications?

 

Just googled it. Responding to licence applications (initial response, not detailed if someone needs additional information) doesn't look like it will actually lose a GP surgery much money (if any).

Edited November 16, 2016 by BrowningB525

[Bigmax1701]

I took this from the press release

 

The new BMA guidance still says that GPs may charge for processing firearms licence applications but it re-emphasises that doctors cannot simply ignore the initial contact letter from the police or delay a reply, as this places them at professional risk.

 

So I take it that doctors have to reply.

 

We don't pay for a appointments so why should we pay for the initial response? It'd take the same time slot but with the bonus of the doc having a brew at the same time

Edited November 16, 2016 by Bigmax1701

[Wb123]

Are GPs not paid for the number of registered patients? Therefore are not losing revenue replying to licence applications?

 

Just googled it. Responding to licence applications (initial response, not detailed if someone needs additional information) doesn't look like it will actually lose a GP surgery much money (if any).

Sort of. A fee per patient which ranges wildly between roughly 80-160 pounds per patient per year. This is for the large part made up from points based targets which are rather resource intensive to hit. There is a base flat rate but no surgery will be viable for just that, the bit that pays the bills is the 'quality outcomes framework' points.

 

Given that going through the notes in any depth will generally take a good ten to fifteen minutes, longer in complex cases, plus admin time to actually respond, at the £200 an hour break even point versus doing 'qof' work for the gp to respond is reasonably looking like at least £50.

 

That said, if you are happy for one of the admin girls to flick over the clinical coding and then reply as no concerns a lower fee could be very achievable. But given my experience of the quality of coding and records i dont think i would want to be nominally responsible for replying as no concerns without reviewing the records myself.

 

 

On a related note i had a chat with a colleague who does only private gp work. They will take a quick history and send a letter outlining no reported concerns for £40 if you can get it all done in a 15 minute appointment slot, but as yet none of her patients have asked for this so we have yet to find out if the local firearrms licencing lot accept it. The advantage of going private is that the much lower overheads often lead to lower prices for non nhs services. A good example is hgv medicals, £120 at many nhs places i have worked, but around £50 elsewhere.

[TommyB]

I would just book an appointment and when I got into the office say I suddenly felt lots better. But as you have allocated me the time slot that I have paid for through my taxes you can use it to respond to my licensing department like a good public servant.

[kody]

Jesus what **** all this docs stuff enough to make the Scotts give up there guns

Perhaps this is what its designed for

[mossy835]

thats more like it,and more to come.

[McSpredder]

A fee per patient which ranges wildly between roughly 80-160 pounds per patient per year. This is for the large part made up from points based targets which are rather resource intensive to hit. There is a base flat rate but no surgery will be viable for just that, the bit that pays the bills is the 'quality outcomes framework' points.

NHS doctors were at one time paid to treat the sick and help the remainder of the population to stay healthy. Nowadays it seems there are incentives to have as many people as possible diagnosed with particular conditions (eg diabetes), prescribed statins, given 'flu jabs, etc, etc, and to carry out admin systems reviews. Sounds like a crazy system, but your own doctor probably has no choice in the matter. Here are some activities that score a lot of points for GPs under Scotland’s “Quality and Outcomes Framework”:

http://www.isdscotland.org/health-Topics/General-Practice/Quality-And-Outcomes-Framework/2015-16/index.asp

"The Practice conducts a safety climate survey with all staff, clinical and non clinical, using a validated tool, meets to discuss the results, and shares a reflective report on actions that arise from this with the NHS Board."

"The practice will undertake a review of access, using the tool agreed between SGPC and SG and provide a practice action report of the findings to the NHS Board."

"The contractor has regular (at least 3 monthly) multidisciplinary case review meetings where all patients on the palliative care register are discussed."

"The practice conducts two case note reviews, using a validated tool, to detect patient safety incidents, meets to discuss the results, and shares a reflective report on actions and themes that arise from this with the NHS Board."

"The practice meets with the NHS Board prescribing adviser at least annually and agrees 3 actions related to prescribing."

"The practice participates in a process of continuous quality improvement by undertaking a review of data set, agreed between SGPC and SG, provided by the NHS Board. The practice provides an annual report, on a template agreed between the SG and SGPC, and participates in a 3 yearly peer review visit."

 

Remember the quote from that old poster? "Meetings -- the practical alternative to work."

 

 

[Wb123]

NHS doctors were at one time paid to treat the sick and help the remainder of the population to stay healthy. Nowadays it seems there are incentives to have as many people as possible diagnosed with particular conditions (eg diabetes), prescribed statins, given 'flu jabs, etc, etc, and to carry out admin systems reviews. Sounds like a crazy system, but your own doctor probably has no choice in the matter. Here are some activities that score a lot of points for GPs under Scotland’s “Quality and Outcomes Framework”:

http://www.isdscotland.org/health-Topics/General-Practice/Quality-And-Outcomes-Framework/2015-16/index.asp

"The Practice conducts a safety climate survey with all staff, clinical and non clinical, using a validated tool, meets to discuss the results, and shares a reflective report on actions that arise from this with the NHS Board."

"The practice will undertake a review of access, using the tool agreed between SGPC and SG and provide a practice action report of the findings to the NHS Board."

"The contractor has regular (at least 3 monthly) multidisciplinary case review meetings where all patients on the palliative care register are discussed."

"The practice conducts two case note reviews, using a validated tool, to detect patient safety incidents, meets to discuss the results, and shares a reflective report on actions and themes that arise from this with the NHS Board."

"The practice meets with the NHS Board prescribing adviser at least annually and agrees 3 actions related to prescribing."

"The practice participates in a process of continuous quality improvement by undertaking a review of data set, agreed between SGPC and SG, provided by the NHS Board. The practice provides an annual report, on a template agreed between the SG and SGPC, and participates in a 3 yearly peer review visit."

 

Remember the quote from that old poster? "Meetings -- the practical alternative to work."

 

 

Bang on, people feel they have paid for a service which in essence the gp is not being paid to provide.