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>The payment system should be drastically simplified, and as a
>starting point, I suggest the idea of giving each GP the net
>intended annual remuneration, removing all item of service payments,
Hoho! Human nature will then dictate that vacc targets, smear percenatges,
and all the other current IoS will take a nose dive
>and then applying guidelines of good practice via a clinical
>governance framework to identify where work which should be done is
>not being.
And then use the stick? Financial penalties?
>I believe the money and time saved would be sufficient
>to run the clinical governance system, provide many of the missing
>resources that are the key determinants in whether good practice can
>be applied, and still leave enough over to spread equitably among
>GPs as an increase in "salary".
Agreed that current system should be scrapped. I don't disagree with your
thoughts but am pessimistic that with no incentives to maintain, say smears
at 80% plus then levels would drop. Even under the old system without
targets at least one was paid for each smear.
I take it that average intended remuneration would be on average list and be
pro rata? I would be very tempted to off load some 300 of my heavy users if
not!
Paul Attwood
GP Thanet
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