GPs to be judged by points system By Dennis Fowle


LOCAL GP practices are to be judged on much of their work by a new points system – and will be financially rewarded if they hit targets. The GP-led NHSWest Kent Clinical Com- missioning Group, now in charge of the bulk of local NHS funds, agreed to use the incen- tive system at its last meeting. This is how doctors can earn points:


 PHONE ACCESS: Patients give views on ease of access and 95% approval earns max- imum points and below 55% no points. Maximum points available: 10  APPOINTMENTS: Patients report on their experiences in being able to make appoint- ments. 95% approval earns top points and 60% and below no points. Maximum points available: 10  RECOMMEND PRACTICE: Thismeasures the percentage of patients recommending the practice with 95% approval earning top points and below 60% no points. Maximum points available: 10  DISEASE: GPs are challenged to increase the recording of diagnoses on their registers of diabetes, hypertension and chronic ob- structive pulmonary disease, leading to faster and better patient care. The overall target is 15%against a baseline and points can also be gained individually in the three categories for 5% and 10% improvements in diagnoses. Maximum points available: 20  EMERGENCY ADMISSION: GPs are chal- lenged to reduce emergency admissions to


hospital for 19 ‘ambulatory care conditions’. These could include chest and abdominal pains, falls and cellulitis. Maximum points available: 10  DISCHARGES: This is based on the per- centage of patients discharged after the first hospital attendance (ie – the hospital team do not feel their expertise can help further). The aim is to improve patient care by only refer- ring to hospital when clinically appropriate. Maximum points available: 10  PRESCRIBING: Points are awarded for the level of under-spend in the practice’s budget for prescribingmedications. Maximum points available: 10 REFERRALS: The aim is to ensure referrals to hospitals are consistent and reflect a clin- ical need. Specialities concerned are trauma and orthopaedics; general surgery, urology, gynaecology; ophthalmology, ear-nose-throat and cardiology. Excluded are cancer and ur- gent referrals. Targets are set individually for each practice.


THE commissioning group says the points sys- temis being set up “to incentiviseGPpractices to improvepatientcareandexperience, improve quality of care and support the Care Closer to Home national agenda”. It says it supports the aim of “improved satis- faction, reduced variabilityandimprovedaccess in primary care in particular, to develop collab- orative commissioning contracts with primary care and community services that reduces


Home treatment for acute health problems


A NEW enhanced rapid re- sponse service is likely to be contracted to deal with acute phases of patients’ health in their own homes to prevent costly hospital admissions. It is being piloted by the GP-


led West Kent Clinical Com- missioning Group, which sees the service helping mainly the elderly using community geria- tricians and senior nurse prac- titioners to develop and implement care plans. Another significant aim of the service is rapid discharge from hospital for people with long- term conditions and complex health needs. The service will include “clinical treatment, rehabilita- tion and support, linking with reablement programmes and focus on enabling the person to regain independence as quickly as possible and remain safe and independent at home”. The aim is to respond to pa-


tients in crisis. Community teams will include clinicians with experience in acute medi- cine and also senior nurses with advanced skills in diagno- sis, treatment of and prescrib- ing for complex health conditions, including acute confusion and dementia. The team will manage such conditions as urinary tract in- fection¸ administration of neb-


ulisers and oxygen therapy. It will also undertake diagnostic tests, interpret and implement an appropriate treatment plan including remote or direct mon- itoring, urgent bloods, radiol- ogy and ECGs. A patient’s carer will be sup- ported and provided with in- formation, advice and guidance for referral to voluntary and domiciliary agencies. This service will also cover residents of nursing and resi- dential homes, extra-care hous- ing and day care services. The group has published a


list of 18 clinical conditions suited to the new service. They include: heart failure, forms of pneumonia, non-fracture falls, dementia crisis, acute confu- sion, gastroenteritis, some urol- ogy, palliative end-of-life care, recovery from injury or surgery, high-level tube feeding, breath- ing problems and cellulitis. The service is on call 24 hours


a day, including weekends, to a maximum of 96 hours at a pa- tient’s home with on-going as- sessment and, where needed, referral for longer-term treat- ment or community support. Access to the service will be through a single point perma- nently manned by a clinician, with a maximum two-hours re- sponse time in emergencies and one hour for acute cases.


Maximum points available: 40  PATHOLOGY: From next April 1 GP prac- tices will be charged individually for tests or- dered ‘to raise awareness of the relevance of investigations – thereby improving efficiency, patient experience in their pathway and managing budgets.’ By hitting all targets a GP practice would


be rewarded with £1 per patient per year (40p pathology, 60p the rest). Payments fall for partial successes. The group says much of the required infor- mation is already available in the system and therefore should not add substantially to workloads and costs. The West Kent Commissioning Group ac- knowledges “various concerns” among GPs about what is titled the “local incentive scheme” and says these must be considered to prevent setting it up for failure. The September group meetingwas told the financial return of the system was likely to be “three or four times expenditure”.


System aims to improve patient experience


health inequalities and achieves better out- comes”. The group says it aims “to promote the ethos


of putting GPs at the forefront of decision mak- ing by ensuring the right care at the right place at the right time – provided by the right work- force to all patients. The starting point for all this is at theGPpractice with the joint decision by the patient and GP on themost appropriate pathway to access”.


Jenson is centre’s 800th baby WEIGHING in at exactly 7lb, Jenson James Evanswas the 800th baby to be born at theMaidstone Birth Centre. Kelly Reeves (24), from Maidstone,


gave birth to Jenson at 5.30am on Fri- day, August 23. She said she chose MaidstoneBirth Centre becauseof the staff and friendly atmosphere. “The centre is relaxing andwelcom-


ingand the staff are so friendly and re- ally good. It feels amazing. Jenson is gorgeous and we’re just so happy.” Kelly and partner Josh Evans are pic- turedwith Jenson. The centre opened in September 2011, Approximately one in five of Maidstone’s mums choose to give birth there.


Girls raise money for cancer group THREE schoolgirls handed over a cheque to Maidstone and Tun- bridgeWellsNHSTrust chief executive,Glenn Douglas, towards the gynae-oncology sup- port and help group (GOSH). Sisters Emily (10)


and Rachel Gadd, and their friend, Megan Carr (10), raised the money at a cake stall at their school summer fair.


Emily and Rachel’s


The girls with Glenn Douglas, Vickie Dadd and her nursing colleagues


mum Vicky, who is a Macmillan gynae-on- cology clinical nurse specialist helps run the


GOSHgroup. She said: “The girls came upwith the idea themselves and while they asked for help making the cakes, they did much of the other organisation and work on their own. They have done a brilliant job.” The girls, who attend Madginford Park Junior School, sold hun-


dreds of cakes and shortbread, along with a variety of toppings for their visitors to decorate them with. They raised £165, and donated £100 to theGOSHgroup, and the other £65 to their dance school, Di- rections Performing Arts, towards some new mirrors.


To contact Downs Mail just phone 01622 630330 South 27


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56