May 28, 2013

Outsourcing GP coverage – the true cost of out of hours coverage and how it works

We have had a GP practice manager contact us to explain how the GP out of hours system works.  In the process we have identified a potential scam.

In essence, to provide out of hours coverage, the government pay a lump sum to each GP surgery.  The amount paid to the surgery is determined by such factors as the size of the practice and of course, the numbers of patients who are registered.

GP’s can opt to provide coverage, in house or they can choose to outsource it to a private contractor, who provides, “111” telephone assistance.  If the GP’s patient ends up at a walking centre, now run by private contractors, the GP is sent a bill – the walk in centre is paid on a “per patient” basis – they invoice the patient’s GP surgery.

Very often, the person who answers the  “111” call is not a doctor and as a consequence, even the slightest ailment is referred to the local walk in centre.  Ironically, the local walk in centre is often run by the same company as the company that takes and administers the “111” calls.  Clearly, there is a financial advantage in referring as many patients as possible to the walk in centre.

Since the implementation of the new system, we understand costs have risen by at least 50%.  If you are a GP or practice manager, who can throw some light on the anomaly, we would like to hear from you.


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