The Advice and Guidance (A&G) scheme sees GPs consult specialists on patient care, aiming to reduce hospital admissions and move treatment into the community.
Incentivising this scheme, and putting the £80 million budget for A&G to good use, GPs will earn £20 every time they consult A&G instead of referring a patient directly to hospital. As a result, the UK government hopes to see a reduction in elective waiting lists and unnecessary hospital admissions. January’s Road to Recovery NHS mandate put an emphasis on community care to aid hospital congestion, which this scheme is poised to support. Let’s have a look at what this will mean for UK GPs, patients, and the system at large.
NHS primary care changes can have a notable impact on the day-to-day running of local GP offices, and the introduction of this scheme is no exception. Firstly, the £20 financial incentive will definitely motivate General Practitioners to follow the guidelines of this incentive; even the most change-averse GP can be swayed by monetary compensation! It’s also likely that a sense of pride and recognition for GPs across communities will be felt, as they play a vital role in the movement towards complex care in the community. Relationships between GPs and specialist physicians will likely strengthen, and trust in each other’s professional opinion will deepen. Another possible effect of this scheme’s implementation will be dissatisfaction from GPs due to the additional administrative burden that will accompany the change.
For patients in the UK, access to specialist care could be faster, with treatment provided in the community rather than joining extensive hospital waiting lists. The timeline from diagnosis to treatment shortening will be received well by patients who are eager to access convenient care. However, there is a potential risk that the financial incentive for GPs could discourage referrals to hospital that are genuinely needed, as they adjust to this new normal. A GP’s clinical judgement will be more important than ever, ensuring that decisions made on patient care are based wholly on the person and not financial considerations or quotas.
This scheme was introduced by MP Karin Smyth, who said it will “save time and stop masses of people having to head to hospital for unnecessary appointments”. The initiative is an undoubtedly admirable attempt to take pressure off the hospitals and improve patient quality of care at home; however, change of this level to how GPs operate is bound to come with teething problems.
How you feel about this scheme depends on whether you are a glass-half-full or glass-half-empty type of person. We can look to the positives of this NHS GP payment scheme: shorter patient wait times, improved collaboration between GPs and specialist physicians, faster recovery of patients in the community, and, of course, the monetary gain to GP practices across the country. However, if your glass is looking half empty, you may be concerned about how the GP incentive of £20 per patient may negatively impact the provision of care when hospital referral is best practice. It could also be said that the public may lean on emergency departments should trust in GPs’ clinical judgement be clouded by monetary gain — which would have the exact opposite effect on hospital congestion.
What do you think — a welcome change, or a cause for concern?
