GP negotiators considering extra C+B incentives

GP representatives and the health department’s pay negotiators are looking at ways that GPs can be paid through the GMS contract for taking on Choose and Book.

The government’s key NHS policy on patient choice is dependent on the widespread uptake of Choose and Book but so far very few GPs have been prepared to use it.

Possible methods being considered include the introduction of a directed enhanced service for IT, according to the GP newspaper Pulse. The scheme might include flexible payments depending on whether a practice completed the full booking or simply referred the patient on to a booking management service.

Under the new contract all primary care trusts must commission any directed enhanced service agreed by the health department and all GPs who want to take part are eligible for the payments.

Dr Richard Vautrey, one of the GP negotiators representing the British Medical Association’s GP committee, said a range of options was under discussion.

He told EHI Primary Care: “We are exploring all possibilities about how to incentivise practices but there’s nothing definite yet. We have always said that there’s a workload implication involved in Choose and Book even if you are referring patients to call centres for the bookings to be made.”

Chris Dowse, head of primary care contracting at NHS Employers, confirmed that negotiations were covering the issue.

She said: “Connecting for Health is a priority for the government and the success of its various initiatives is dependent on the support of GPs. As part of our wider discussions with the GPC on the future of the GMS contract, we will be discussing this issue with a view to finding a way forward that achieves the government’s aims and is practical and achievable for GPs.”

Last month it was revealed that only 119 practices out of approximately 9,000 in England are so far using the system. The government’s target that 80 per cent of outpatient appointments should be made using Choose and Book by the end of the year looks increasingly likely to fail.

The target is conspicuous by its absence in Connecting for Health’s first annual business plan which has just been published [PDF, 1.3Mb].

As far as Choose and Book is concerned the plan states only that the intention is for “widespread rollout during 2005 and 2006.”

It also details five dependencies that the rollout will rely on. These include “The engagement of clinicians trained in the use of Choose and Book and associated business processes, as we have no control of GP take-up, consultants’ diaries or the nomination of the specialties to which Choose and Book is extended.”