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Primary Care Blues

Cornelius Rubeus

Thursday, 13 December 2012

shutterstock_60735469[1]11.jpgQIPP – “Quality, Innovation, Productivity and Prevention”

QUIPP – “A smart, sarcastic turn, taunt or jest; a severe retort or comeback”

When I was told at this week’s commissioning meeting that we were ‘over performing’ as a CCG, I started to pat myself on the back for doing my bit to help QIPP achieve the eye watering £20billion of efficiency savings in the NHS by 2014-15.

However, it soon became clear that ‘over performance’ is the latest NHS-speak euphemism for describing how we are over-spending against our planned budget for those inconveniently expensive paediatric emergency attendances, diagnostic tests, elective cardiology procedures and the like…

Actual clinical activity in local secondary care still remains largely shrouded in mystery due to the ongoing data quality issues and rabied ‘up-coding’ of episodes of care.

Never mind… we have received a briefing on ‘High Impact Actions’ (with capital letters) that “individual GPs / Practices can act on to help secure strong performance in the second half of the year”.

My ears pricked up – this will be good I thought – the time must have come for Secondary Care to be challenged on their profligate over-spending and creative accounting.

Imagine my disappointment when ‘the big idea’ was revealed:

  • Arrange for your Practice to be open during opening hours
  • Make your telephone message / triage system user friendly
  • Reduce barriers to booking appointments
  • Offer telephone and face to face options
  • Offer the doctor of patients’ choice
  • Ensure good access for parents with same day appointments at a time of their choice

…The list went on… I zoned out… I’ve given up being angry with them ‘just not getting it’. It was bad enough when it was PCT patronising diktats, but this was nascent CCG, GP-led ‘blue sky thinking’.

For the record, my Practice have managed 13,547 face to face appointments in 2012 – an increase of 27% in 5 years, compounded by 4794 telephone consultations – a staggering 71% rise in demand. I know this trend is mirrored across the Locality.

With more hospital-based care ear-marked for the community to pick up on, sadly we are grossly under-equipped to carry on QIPPing.

QIPP talks about ‘re-investing savings in front-line care’ – it’s time to show me the money

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Cornelius Rubeus

Dr Rubeus is a hardworking, jobbing GP who trained in the North of England and now works in an inner city setting. He feels passionate about the changes affecting primary care and is not afraid to voice his views. He has his patient’s best interests at heart and wants General Practice to remain as the bedrock of the NHS for years to come.
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