Primary care trusts are using funds set aside to develop care
services for hard-to-reach groups to pay off NHS debts and boost
other services, doctors' leaders claim.
The British Medical Association has warned that PCTs that "rebadge"
enhanced services cash to pay for non-community services or to
reduce overspend in other areas would be named and shamed when
their accounts were audited.
It said too many PCTs were failing to "grasp the opportunity" the
new GP contract provided to develop and deliver more services for
hard-to-reach groups in the community, such as asylum seekers,
alcohol and drug misusers, and homeless people.
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The new contract, which began in April, sets out higher rates of
pay to doctors who provide a greater range of services.
BMA negotiator Dr Laurence Buckman said the inconsistent
interpretation by the 302 PCTs in England of what enhanced services
were resulted in patchy provision and "directly affected" patient
care.
"Forward-thinking PCTs realise they can deliver the NHS Plan
through the enhanced part of the contract. But others lack
originality and view every new thing as a threat to their budgets,"
he said.
"The money is there but some PCTs are poorly managed and the only
thing they are interested in is balancing the books. Those
rebadging will get caught."
The London Drug and Alcohol Network said it knew of only a few PCTs
in the capital that had developed specialist alcohol rehabilitation
services through the enhanced part of the new contract, and those
that were on a small scale.
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Dr David Jenner, professional executive committee lead for the NHS
Alliance, admitted some PCTs had not "grasped the nettle", but
insisted some were "strapped for cash".
Meanwhile, the BMA has rejected suggestions by a group of Scottish
rural GPs that it failed to take proper account of patients' needs
during negotiations for the new GP contract.
The 30 GPs, largely from Dumfries and Galloway, have warned that
the new arrangements for out-of-hours health care could put the
lives of patients in rural areas at risk.
Under the new contract, responsibility for emergency care shifts
from GPs to local health boards, with Scottish helpline NHS24
taking all calls and deciding whether patients need a doctor or an
ambulance, or can wait.
The GPs said the ambulance service could not cope with the increase
in emergency calls, and that care of the elderly and terminally ill
would be compromised.
