I am amazed at the stupidity of it. I ran an economic TPP and fund for 7
years, always underfunded (capitation) but living within its means and
handling referrals sensibly at no cost to the NHS.
Now we've left there is a nasty doctor at the HA who vets referrals out of
county and questions you by letter to make sure that you are behaving
yourself and maybe treating your patients with more care than is allowed.
He wrote me a letter because I dared to refer a young stroke victim to a
specialised physio place across the border. I was naive - I believed my
friend Frank when he promised me freedom of referral but little did I know.
I suggested this chap should approach the patient for permission to break
confidentiality and should pay me a fee for my letter and time as it is not
in my terms of service - putting him in the same box as insurance
companies!
He flatly refused to ask for permission (Does the BMA think that is right?)
and suggested I obtained it from the patient (bloody cheek!)
However he agreed to authorise payment for the letter (presumably at
solicitor rates but they need signed permission - he's in the solicitor box
now!)
So the cunning plan - refer all your patients as the old fashioned ECR -
then when you are queried - send a large bill - that will make up for HMG
interfering with our pay award this year, and next, and the one
after........... about £30,000 per GP per annum at a modest calculation!
Rob - ex TPP lead and disgruntled by the stupidity of the reforms!
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