There is a fundamental problem with the lack of fee for a TR/imm
necessary patient and the item of servicet needs to be reintroduced.
The requirement to do any number of TR requests in your area penalises
practices with any sort of reputation who get more work for no
payment. It may have passed me by, but I don't know of any system to
rebalance the TR rate enshrined in the global sum if your TR rates
change, is there one?

I had a TR extra a couple of weeks ago that was only in front of me
because he couldn't get an appt at his own practice 1/2 a mile away,
so there is considerable potential of the walk in work to slosh around
the system if patients are allowed to just pop in wherever they like
with no fee for the work.

The visit bit is just the same issues as the TR issues but x4 because
it takes 4x the time which makes it even more painful.

On 8 June 2011 21:42, Julian Bradley <[log in to unmask]> wrote:
>> The particular factor which has enforced them is the requirement to
>> visit (when condition requires it) at the registered address.
>>
>> Previously the temporary resident item of service fee or the immed.
>> nec. service fee was satisfactory for rewarding a practice who dealt
>> with someone else's patient in the area in whcih they were willing to
>> visit.
>>
>> The only two actions required in order to make it possible to achieve
>> what has been declared to be desired are to change the requirement to
>> visit all patients registered to one to visit within the practice
>> area, and to reinstate those two fees as additional fees to existing
>> income.
>>
>> The Treasury, I'm told, has blocked each previous attempt at this
>> becuse they reject the potential for two doctors to get paid for
>> looking after teh same patient.
>>
>> I'm neutral on this.
>>
>> Adrian Midgley
>
> Thanks both.
>
> Interestingly (for me anyway) BBC had a piece on this on News 24.  They gave
> a very even handed account, interviewing a patient, an individual GP at the
> practice that was unable / unwilling to register her, and Dr Gerada from the
> RCGP.
>
> At the moment the two opposing views seem to have resulted in a bit of a
> dialogue of the deaf, and the government needs some sensible ideas to
> resolve this in everyone's interests before some well intentioned
> incompetence (?at least partly the responsibility of the civil service)
> causes inevitable problems, likely more significant than any benefit.
>  Whether those ideas will even be heard if they come from the profession is
> another matter, we can but hope.
>
> I think we need to acknowledge there is a problem, and seek a solution that
> will work - not what is on the table at present.
>
> J