GP practices given cash back for not sending patients to hospital

GP practices are being given “cash back” for preventing patients from going to hospital, under “profit-share” agreements, which were last night condemned by patients’ groups.An investigation reveals that one in four NHS authorities has introduced financial incentives for GP practices which reduce the number of patients referred to hospital.They include schemes which mean practices can keep up to half of all savings generated, if they stop any rise in the numbers going to hospital, despite an ageing population. Others receive an extra £5 for every patient kept out of hospital, if referrals are cut by 10 per cent, under a £1.4m scheme.Patients’ groups said the policies were “truly disgusting” while leading GPs described the schemes as “ethically questionable” as they called for them to be halted.It comes amid polling showing satisfaction with GPs has slumped to the lowest level in 35 years, with a sharp fall in the last year.

Think tanks said the findings from the British Social Attitudes survey were alarming, with a service once seen as “the jewel in the crown of the NHS” was “really in decline” with satisfaction levels falling by seven per cent in just one year.Freedom of Information disclosures from 181 clinical commissioning groups (CCGs) reveal 44 are now offering practices financial incentives in order to cut referrals to hospitals.Many practices received a financial boost for setting up systems which meant every referral was double checked by another clinician before being allowed to go ahead.But the investigation by Pulse also reveals eleven schemes where sums paid out were directly linked to cutting referrals, including “profit sharing” schemes which meant practices could receive up to half of all savings made.CCGs said the schemes aimed to reduce unnecessary referrals, which would improve outcomes for patients. They said savings should be reinvested in services, not paid to GPs, whose earnings are derived from practice incomes.

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