GPs taking part in the choice and booking incentive scheme are expected to hand out surveys from the beginning of this week to measure the percentage of patients offered choice at referral.
Practices must hand the questionnaire to all patients where an eligible referral is made between 16 January and 30 March 2007 and patients can then return the survey to research company Ipsos MORI in a reply paid envelope.
Distributing surveys via practices is expected to be an interim arrangement for this year because it was not possible to include the choice question in the access to GP services survey also being conducted by MORI. However it is intended choice questions could be included in an access survey from next year.
The choice component of the directed enhanced service (DES) is worth 48p per patient to practices of which half has been paid in advance as an aspirational payment to those agreeing they would offer choice.
Primary care trusts (PCTs) must arrange for repayment of the aspirational payment, or offset the repayment against other income due to the practice, if less than 60% of patients agree they were offered a choice of provider.
The survey mechanism for the DES has been consistently criticised by GPs who claim their income will be dependent on patients’ memories. The Department of Health’s own bi-monthly surveys on choice this year have so far shown only about 30% of patients recall being offered choice at referral.
The DH has also issued guidance to PCTs on measuring the e-booking component of the DES. The guidance says PCTs are responsible for assessing and making payments to practices.
It says information on total number of referrals made by practices is available in waiting list returns and information on referrals via Choose and Book is collected by the Choose and Book system.
Frequently asked questions addressed by the guidance include:
• what happens if a practice generates a unique booking reference number (UBRN) which is not converted,
• what counts as a referral,
• what happens if a booking is subsequently cancelled and
• what happens if the Choose and Book system is not working.
On this point the guidance says: “If, by the end of 2006/07, a practice has not been able to implement Choose and Book due to circumstances beyond its control (e.g. due to national or regional difficulties), the commitment to award payment to practices will still hold and the practice should receive a pro-rata payment for the work that they have completed. This payment is to be decided by the PCT.”
Payments will be made to practices on a sliding scale for practices achieving between 50% and 90% of referrals electronically between 1 September 2006 and 28 February 2007. Only about a third of referrals were being made through the system nationally by the end of December. Practices not achieving the minimum 50% threshold will have to pay back their aspirational money.
Links
Briefing on choice of hospital survey
DH Guidance on Choose and Book payments