‘Cash for diagnoses’ dementia scheme is dropped

Ivan Annibal — Wed, 26 Nov 2014 22:32:52 +0000

I commented on this story previously. This article suggests some very strange attitudes amongst doctors who didn’t agree with the principle but were prepared to take the money anyway. Now the policy is being abandoned. The principle of being paid for diagnosing has not changed in other aspects of GP’s work. I still think we need to understand the incentives GPs get for these other aspects of their work. The article tells us:

Simon Stevens, NHS chief executive, said the initiative, which met a backlash from doctors and patients, will end in April – the Government deadline for a target to improve diagnosis rates.

The national scheme was branded “an ethical travesty” by some GPs, 50 of whom wrote to Mr Stevens calling for the payments to be axed.

Leading GPs said that giving says that giving doctors financial rewards for diagnosing patients set a “dangerous precedent” which could break the trust between them and their patients.

They said the scheme, aimed at improving diagnosis rates for the condition, could have “truly tragic consequences” – in encouraging doctors to incorrectly label patients as suffering from the condition.

Earlier this month a poll of 600 GPs found that two thirds thought the scheme was not ethical – but almost half intended to take the payments anyway.

NHS’s new non-emergency 111 telephone service is unsustainable, warns provider

Ivan Annibal — Wed, 03 Jul 2013 20:31:27 +0000

I was listening to the controversy about illegal immigrants having to pay to see a GP today. The main thrust of those against this approach was that the individuals will just present instead at A and E. I wondered about this phenomenon in the light of this story about how the 111 phone line is failing. It made me reflect more broadly on the challenges of providing health services to people in more remote communities – particularly those suffering from “access poverty” when services which are remote from remote people fail. Not a good thought – the article tells us:

The crisis over the NHS’s new non-emergency 111 telephone service has deepened after a major provider pulled out of two regions and warned that its entire service was “unsustainable”.

NHS Direct won 11 of the 46 contracts to provide the new 111 service, which has been plagued with problems since it went national in April.

But in a major blow to the service, which has been backed by the health secretary Jeremy Hunt, NHS Direct has said it is “not in a position” to provide services for North Essex and Cornwall and that each of its 11 contracts are not “financially sustainable”.

In two areas – the North West and the West Midlands – NHS Direct has only been able to take between 30 and 40 per cent of the calls it was contracted to handle, with staff unable to cope with demand.

The 111 service was piloted last year and was rolled out nationally in April. After complaints about calls going unanswered and poor advice being given by operators with no medical expertise, NHS chiefs admitted that patients had been “let down” by the service. The phone line has been blamed for heaping pressure on A&E wards. A number of deaths and several serious incidents are being investigated by local health authorities to discover whether failings in the 111 service played a part.

GP Services – Hinterland

‘Cash for diagnoses’ dementia scheme is dropped

NHS’s new non-emergency 111 telephone service is unsustainable, warns provider