GPs have been told by Clinical Commissioning Groups (CCGs) they will have to hit targets for cutting emergency admission rates.
If they do not they will not receive funding worth £5 per patient promised to them to support the care of elderly patients, Pulse magazine has revealed.
A Pulse investigation reveals that 86 of 150 CCGs have not yet committed funding to support GPs in rolling out the new Unplanned Admissions Direct Enhanced Service (DES) and supporting the care of elderly patients, despite a pledge from NHS England to commit £5 per patient to fund this.
The investigation also reveals that at least four CCGs have made the funding conditional on targets being met, including reducing hospital admissions rates and care home interventions.
GP leaders said it was ‘wholly inappropriate’ to set targets to reduce admissions rates.
A Freedom of Information request to CCGs across England asked how they were intending to identify and spend funding cited for ‘transforming the care of patients aged 75 or older’, which NHS England said ‘should be at around £5 per head of population for each practice, which broadly equates to £50 for patients aged 75 and over’.
• About 10% of CCGs said they have already committed to giving the full £5 per patient to GP practices;
• 16 out of 150 CCGs said they are giving some proportion between nothing and £5 to GP practices;
• 10 CCGs said GPs had to earn this extra cash through measures such as additional care in nursing homes, care planning and medicines reviews in care homes;
• 11 CCGs described services they were commissioning that would not directly involve GPs.
NHS West Suffolk CCG and NHS Ipswich and East Suffolk CCG have made half of this funding dependent on whether practices have delivered on ‘agreed outcomes’ by April 2015. It added: ‘All schemes are expected to contribute towards a reduction in avoidable emergency admissions in patients aged 75 and over.’
NHS East Leicestershire and Rutland CCG has also agreed to give half the funding upfront, with the remaining 50% to be based on targets, including those relating to COPD, diabetes and atrial fibrillation.
Meanwhile, NHS Leeds South and East CCG will give GPs up to £5 depending on achievement against the region’s ‘Practice Engagement Scheme’, which encourages greater involvement of GP practices in commissioning.