If you have an ECG heart recording performed at Pilgrim Hospital, the NHS pays ULHT (United Lincolnshire Hospitals NHS Trust) £59. If you have your ears irrigated at the hospital this costs the NHS £85. A spirometry breathing test is valued at £216. This work isn’t considered part of GP practices’ core work. How much are local GP surgeries reimbursed if they want to carry of the same tests – to pay for the staff time, staff training, equipment, its calibration and consumables? Not a penny!
In recent months the local Federation of GP practices has been in discussion with a very reluctant CCG (Clinical Commissioning Group) about work which practices have historically carried out at a loss. (Remember we are currently funded at approximately only £145 per patient per year to provide unlimited essential care.)
The GP Federation could have performed these procedures and others far more cost-effectively than the hospital, but the CCG refused to discuss a price per procedure. The Federation calculated that practices might break even at £3.48 per patient per annum based on the historic number of procedures carried out. The CCG offered GPs just £1.68 per patient per year to carry out as many ECGs, heart and blood pressure monitors, ear irrigations and spirometry as were necessary.
The NHS professes to wish to deliver more patient care nearer to your home, but GP practices can’t run on goodwill alone. We are small businesses with staff to pay (ignore the headlines – we were given 1%), and bills to meet. The GP Federation has told Lincolnshire East CCG that we can’t carry out the work at this price. The CCG has said it will look elsewhere for someone to do the work for £1.68. Good luck with that – who would possibly contract to undertake unlimited work for a pittance? In the meantime the CCG will continue to pay ULHT £59 for a test that can be done in 5 minutes, wasting the limited funds of taxpayers’ money at its disposal.