Care trusts told to stop siphoning off money meant for hard-to-reach

    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.

    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.

    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.

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