NHS Bungs Paid To GPs & Nurses : To Prevent Care

Discuss news stories and political issues that affect carers.
Oh dear , now we really are seeing something ?


https://www.theguardian.com/society/201 ... o-hospital


GPs offered cash to refer fewer people to hospital.

Four NHS commissioning bodies in England offer to share savings made with GP practices.


GPs are being offered cash payments not to refer patients to hospital, in a move which leading family doctors have criticised as ethically questionable and a risk to health.

NHS bodies in four parts of England are using schemes under which GP practices are given up to half of the money saved by sending fewer patients to hospital for tests and treatment.

The disclosure by the GP website Pulse about the controversial “profit share” initiatives operated by the four NHS clinical commissioning groups (CCGs) has triggered a row.

Critics said the schemes were the latest example of NHS bodies increasingly resorting to the rationing of care to help them operate within their budgets.

NHS Coastal West Sussex CCG has offered to give groups of practices working together in its area 50% of savings made from GPs referring fewer patients for dermatology care, ear, nose and throat treatment in the community, and minor surgery and wound closure.

Helen Stokes-Lampard, chair of the Royal College of GPs, said: “Cash incentives based on how many referrals GPs make have no place in the NHS, and frankly it is insulting to suggest otherwise.” Family doctors did need help to ensure they were refer the right patients but that should not involve “ethically questionable initiatives that prioritise cash savings over patient care”, she said.


Peter Swinyard, chair of the Family Doctor Association, said: “From a patient perspective it means GPs are paid to not look after them. It’s a serious dereliction of duty, influenced by CCGs trying to balance their books.”

England’s 207 CCGs hold the budget for the NHS locally and decide which services are provided for patients. NHS West Leicestershire, which is offering federations of GP surgeries 30% of savings resulting from fewer “first referrals”, said the scheme was designed to cut the number of “clinically unwarranted and unnecessary referrals, particularly into secondary care” and would let hospitals treat the most needy cases.

A freedom of information survey of 181 CCGs by Pulse found that a quarter offered some sort of financial incentive to GPs to cut referrals. Eleven involved a direct incentive to GPs to alter their referral behaviour, four of which involved “profit-sharing” schemes.

NHS England, which funds and supervises CCGs, declined to comment, but Amanda Doyle, co-chair of NHS Clinical Commissioners, which represents CCGs, said: “Ensuring patients get the best possible care against a backdrop of increasingly squeezed finances is one of the biggest issues CCGs face. Directly linking payments to reductions is not appropriate and NHS England, as the regulator, would take a role in addressing that circumstance.”

Jonathan Ashworth, Labour’s shadow health secretary, said: “Minister should step in and ban this practice immediately. Patients should be referred for treatment on the basis of their medical needs. These cash handouts – which some might even describe as ‘bribes’ – to block referrals are totally unacceptable and the latest pernicious effect of Tory underfunding of our NHS.”

The Department of Health and Social Care made clear that no patient should be denied care. “Patients must never have their access to necessary care restricted - we would expect local clinical commissioning groups and NHS England to intervene immediately if this were the case,” a spokesperson said.


" Sorry squire , I get 'alf a monkey for NOT refering you to the specialist. "

" Make it 300 notes of the realm and I might drop 'im a line. "

Has it really come down to this ???
Im hoping its not related to the fact i had to phone GP this morning to chase a referral for my eye which was requested on 22nd January. "Oh I see from the note it was requested" said the receptionist "but he must have forgotten to dictate the letter so it hasn't been sent yet" :roll:
" Cross my palm with silver " ... seems to be the only way ... with some ?
I'm sure this has been going on unofficially for a long time. Ask for a referral to a consultant and you are told you don't need one at the moment. Say you want to go private and you are referred immediately.
Ask for a joint replacement on the NHS and you are told to get rid of some weight first. Privately, not a problem at all.

My consultant did some research and his resultant report found that the success of a new knee wasn't affected at all by the weight of the patient. He's a top consultant, lectures abroad at times.
More sinister one from today's edition of the Daily Chuckle :


http://www.dailymail.co.uk/money/news/a ... nding.html


Nurses paid £110,000 to strip dementia sufferers of their care funding: Latest disturbing twist in our probe into cutbacks hitting the elderly

Nurses are being offered the equivalent of more than £100,000 a year to evaluate whether terminally ill cancer patients and dementia sufferers should be stripped of NHS funding for their care.

A Money Mail investigation today reveals precisely how health authorities are depriving nursing home residents of this money.


Four weeks ago, we revealed that soaring numbers of people suffering from degenerative conditions are having care payouts removed after reassessments.

We have since been inundated with letters from families whose loved ones face being turfed out of nursing homes or draining their bank accounts to pay for help.

Now, we can publish details of how these seemingly heartless decisions are being made. Our findings include that:

A staffing shortage has forced local health authorities to pay nurses huge sums — just as officials try to slash care spending.
Crucial decisions on funding are being made by panels of people who have never even met those in need of help.
Vital reports on care needs are littered with mistakes, such as repeatedly confusing the sex of a patient.
One nurse described, in an internal health authority document, how the purpose of her work is to 'screen out' funding, rather than to check on a nursing home resident's health.

Cash-strapped local health authorities have been ordered to save £855 million from their care budgets, while staff shortages mean Clinical Commissioning Groups (CCGs) are shelling out huge sums for temporary nurses to carry out care assessments.

Supreme Hill Care Limited, a London-based recruitment firm which supplies nurses to fulfil these checks — known as continuing healthcare (CHC) assessments — is offering assessors up to £480 a day, the equivalent of £110,000 a year.

The CHC payment to patients is typically worth around £1,000 a week and is awarded to people with severe or unpredictable health needs. Crucially, their needs must be mainly health-related, rather than social, such as requiring help to dress and wash.

When funding is granted, the care recipient is reviewed by a nurse annually. If their needs are judged to have changed, a full reassessment is carried out by a team of nurses and social workers.


The Supreme Hill Care website says it has recruited assessors for five local health authorities, including Aylesbury Vale CCG and Chiltern CCG. An advert from another agency, this time recruiting for an NHS organisation in the Midlands, offers £380 a day — equal to £87,400 a year — for a mid-ranking mental health nurse to deal with older adults.

'This is an enormous waste of resources at a time when elderly people are being forced to sell their homes to pay for care,' says Tory peer and care campaigner Baroness Ros Altmann.

Reassessments are supposed to ensure that a person's needs are being properly met.

A full reassessment must consider this over 12 areas, ranging from mobility and continence to feeding and cognition. But families say they feel as though staff are looking for any reason to axe funding.

Bob Birchmore's 81-year-old mother-in-law, who suffers from dementia with Lewy bodies, which worsens over time, was stripped of funding in June last year by Salford CCG.

Bob, 65, from Bury, used Freedom of Information laws to obtain documents detailing how the decision was made.

In one report, a nurse says she carried out an assessment to 'screen [her] out of continuing healthcare'.

Another report painted a misleading image of Bob's mother-in-law's needs, stating that she 'has enjoyed dancing' when she had merely been watching it on the television. Salford CCG says it cannot comment on the case.

NHS guidelines state that at a full reassessment, a team of professionals should try to see the care recipient in person. Family members should also be invited to attend and given 'sufficient' notice.

However, some families say only one nurse attended their meetings, which means some funding decisions are being made by people who have never even met the patient concerned.

'I now rarely attend assessments where a full multi-disciplinary team is present,' says Fiona Lower, a former nurse who now helps families at reassessments.

'The nurse is unable to make a recommendation on their own; a recommendation is made following a team meeting at an office. This therefore denies the patient, the family and advocates the right to comment prior to a decision being made.'


When local health authorities write to families to inform them of their decisions, they enclose a report. In one document seen by Money Mail, a CCG recommends a male dementia sufferer is stripped of his funding — yet repeatedly refers to him using the female pronouns 'she' and 'her'.

The man's wife, who successfully appealed the decision, says: 'How can these documents be used to make crucial decisions if even basic facts are wrong?'

In each of the 12 areas covered by the reassessment a person's needs must be ranked from 'no needs' to 'priority'. Generally, to qualify you must receive one 'priority' or at least two 'severes'.

But the scoring process is a grey area, experts say. For instance, someone could score 'severe' in the mobility category if 'on movement or transfer there is a high risk of serious physical harm and where the positioning is critical'.

But if they were judged to 'need careful positioning due to risk of physical harm' they might get only a 'high'. This lower score could jeopardise their funding.

Stephen Roberts, 66, won back funding for his mother, who suffers from dementia, after recording the October 2016 meeting in which her needs were discussed.

Assessors said his mother, Ethel, 92, who stayed in London through the Blitz to continue her war service making military uniforms, had 'severe' needs.

But weeks later, Stephen, from Bromley, received a report stating that in some crucial areas her needs were only 'high', so her funding had been refused.

Stephen sent his recording to Lewisham CCG and funding was reinstated. The CCG said it would not comment on the 'specifics of any case', but added that it acted 'in line with the national framework for NHS continuing healthcare and NHS-funded nursing care'.

A spokesman for Aylesbury Vale and Chiltern CCGs says 'recruitment and retention of qualified CHC nurses was a national challenge' in expensive areas such as Buckinghamshire.

'The use of agency staff in Bucks is kept to a minimum and is closely monitored,' he adds.


The above article ... if factually correct ... will take some beating.

Perhaps deserves the front page on most daily newspapers ?