News1 min ago
Gp's Managing Their Own Finances...
16 Answers
I think I put this in the wrong section to start with...oops.
If I'm right in thinking that GP's manage their own finances for their practices, can some one answer this please? If they prescribe a treatment.... the practice pays for it, whereas if they refer the patient to a consultant, the hospital pays for the treatment, medication et al? Thanks for your
If I'm right in thinking that GP's manage their own finances for their practices, can some one answer this please? If they prescribe a treatment.... the practice pays for it, whereas if they refer the patient to a consultant, the hospital pays for the treatment, medication et al? Thanks for your
Answers
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To be fair I believe it was Chris who claimed referral costs were borne by GPs which was subsequently queried by Sqad.
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Referral costs are entirely borne by CCGs, currently being incentivised to reduce rates of referral by NHS England and offering bonuses to GPs in fulfilling this reduction.
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Referral costs are entirely borne by CCGs, currently being incentivised to reduce rates of referral by NHS England and offering bonuses to GPs in fulfilling this reduction.
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Gp's have a contract with the local Clinical commissioning group. The group pays for secondary care services and also pays for GP services. If GP practices start referring people to secondary care unreasonably then the CCG will have something to say about it. Hospitals charge for their services per admission episode or per out patient clinic episode and contracts are agreed for a certain amount of episodes broadly by diagnosis. If the CCG uses up less than its contracted number of episodes then it doesn't get a contract refund but if it uses up more than its contracted number then it pays for the extras at a higher rate per episode than it paid for the bulk contract. This is because it sets itself up to fulfil its contracts with little excess so may need to purchase additional episodes from elsewhere and pay extra.
There are other reasons for keeping people out of hospital than saving money. The cleanest of them are an infection risk simply because you are meeting strangers with their own communities of bugs which you may not have resistance to. Even the best of them are noisy and not as comfortable as being at home. They are also disruptive to older people, especially those with alzheimers.
It's not the payment for referral it is who pays for the treatment? If GP prescribes treatment does surgery pay for it. If he sends patient to consultant....does hospital pay for it. I am trying to establish why GP referring to consultant when GP is capable of prescribing treatment. SOZ if I have confused anyone. Thanks guys.
Woofgang @17:22 thanks for that. I just wondered why our GP said if ok for treatment he would struck off .... He said consultant and authorise so has referred to him. To be ho et I think it's because cost cutting for this surgery, he would rather refer to hospital consulTant so GP doesn't have to pay. I may be wrong.....but it looks like he is passing the buck....sigh.
As has been mentioned above GPs effectively have to pay to refer a patient to a consultant. That's because they receive a bonus payment (up to about £11,000 p.a.) for keeping referrals down but that gets cut (by around £100) for each referral they make.
The system is designed to take pressure off hospitals and concentrate health care provision locally but some campaigners blame it for contributing to the UK having the lowest cancer survival rates in Europe (because GPS are reluctant to refer patients to consultants in the early stages).
The system is designed to take pressure off hospitals and concentrate health care provision locally but some campaigners blame it for contributing to the UK having the lowest cancer survival rates in Europe (because GPS are reluctant to refer patients to consultants in the early stages).
the Community Care Group can put controls on what GP's may prescribe provided those limits don't contravene NICE guidelines. They can also put a control on referrals for certain things in the same way. The usual way to put a control in place is to say that the referral must go through the CCG. There may also be screening requirements, ie a person cannot go on the hip replacement referral waiting list without having first seen a Physiotherapist and an Occupational Therapist. This one I know about. It was shocking how many people were given pain relief, put on the surgery waiting list and left to wait while suffering. Other Gps were a pleasure to work with and very switched on of course.
Its most often used for contentious things like cosmetic surgery. The CCG will probably have a group of clinicians so that they can ask for objective clinical advice about such referrals and prescriptions. I have been part of such a group in the past. The idea is to ensure that care and intervention is provided as fairly and equitably as is possible. I have had sight of some of the referral and prescribing stats for GPs with similar caseload demographics and the rates did vary considerably.
Its most often used for contentious things like cosmetic surgery. The CCG will probably have a group of clinicians so that they can ask for objective clinical advice about such referrals and prescriptions. I have been part of such a group in the past. The idea is to ensure that care and intervention is provided as fairly and equitably as is possible. I have had sight of some of the referral and prescribing stats for GPs with similar caseload demographics and the rates did vary considerably.
Chris - "As has been mentioned above GPs effectively have to pay to refer a patient to a consultant."
The only posters to say that are you in your earlier thread and the repeating of such by fiction-factory above.
"That's because they receive a bonus payment (up to about £11,000 p.a.) for keeping referrals down but that gets cut (by around £100) for each referral they make."
That is not how the bonus works. If you meet your quota you get the bonus; if you fail you receive nothing. Your figures suggest that about 110 referrals would obliterate the bonus. Since the incentive is broadly aimed at reaching a sub-25% referral rate this would mean the practice only has 440 registered patients. The average number of patients per practice in England is about 8,000.
As an example:
A practice with 8,000 registered patients has a quota for fewer than 2,000 referrals to earn a bonus of £10,000 (equivalent to £1.25 per registered patient).
For 1,700 referrals the full bonus is paid - a gain of £1.25 per
For 1,900 referrals the full bonus is paid - a gain of £1.25 per
For 2,100 referrals the bonus is not paid. It is not a cost to the practice other than a loss of a potential gain of £1.25 per registered patient. However, it is 'effectively' the practice either paying £10,000 for all 2,100 referrals (£4.76 per) or for 100 quota-busting referrals (£100 per).
For 2,200 referrals the 'effective' cost is £4.55 per or £50 per (according to how you slice it) but again is really a loss of a potential £1.25 per.
The only posters to say that are you in your earlier thread and the repeating of such by fiction-factory above.
"That's because they receive a bonus payment (up to about £11,000 p.a.) for keeping referrals down but that gets cut (by around £100) for each referral they make."
That is not how the bonus works. If you meet your quota you get the bonus; if you fail you receive nothing. Your figures suggest that about 110 referrals would obliterate the bonus. Since the incentive is broadly aimed at reaching a sub-25% referral rate this would mean the practice only has 440 registered patients. The average number of patients per practice in England is about 8,000.
As an example:
A practice with 8,000 registered patients has a quota for fewer than 2,000 referrals to earn a bonus of £10,000 (equivalent to £1.25 per registered patient).
For 1,700 referrals the full bonus is paid - a gain of £1.25 per
For 1,900 referrals the full bonus is paid - a gain of £1.25 per
For 2,100 referrals the bonus is not paid. It is not a cost to the practice other than a loss of a potential gain of £1.25 per registered patient. However, it is 'effectively' the practice either paying £10,000 for all 2,100 referrals (£4.76 per) or for 100 quota-busting referrals (£100 per).
For 2,200 referrals the 'effective' cost is £4.55 per or £50 per (according to how you slice it) but again is really a loss of a potential £1.25 per.
So is it just a matter of semantics- Buenchico says some GP's effectively pay something becaus ethey lose a bonus; others say that losinga bonus is not the same as paying.
Anyway, I don't know- I just said I recall I'd read it somewhere recently- it was quite possibly from one of Buenchico's posts or it may have been mentioned on one of those GP surgery programmes.
Anyway, I don't know- I just said I recall I'd read it somewhere recently- it was quite possibly from one of Buenchico's posts or it may have been mentioned on one of those GP surgery programmes.
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