HM Primary Care

GPs are advocating private treatment to patients due to the limitations of clinical commissioning group (CCGs), according to Spire Healthcare. 70% of GPS tell patients who don’t meet requirements for procedures of limited clinical effectiveness, they should go private. 62% of GPs are telling patients to wait until their condition worsens. Spire Healthcare has surveyed 824 GPs in England to learn about procedures limited by their CCG and the advice they give to patients who do not meet the eligibility criteria set for surgery. 63% of GPs – up from 30% in 2011** - are indicating to their patients that they should consider using their private medical insurance where they have this. 80% of GP-led CCG’s appear to have identified their procedures of limited clinical effectiveness’ (PoLCE). Surgery for varicose veins, tonsillectomy, carpal tunnel syndrome and hernia repair topped the list - despite varicose vein and hernia surgery being two of the four NHS funded procedures followed up using Patient Reported Outcome Measures or PROMs. One in six GPs also stated that knee arthroscopy, knee replacement, hip replacement and cataract surgery, have also been either restricted of had their criteria for proceeding to surgery increased.

The new NHS non-emergency telephone line, NHS 111 hit a bump in the road last month as one of the providers, NHS Direct, admitted that offering the service in some areas would be unsustainable’.

Monitor is to examine the commissioning and provision of GP services in England to see if there are barriers preventing patients from securing access to the best possible care. The health sector regulator wants to hear from patients, GPs, commissioners and other providers of primary and secondary care.

NHS England and the Health and Social Care Information Centre (HSCIC) has started a new procurement process for an expanded framework of IT services and solutions for GP practices. The new GP System of Choice (GPSoC) contract will replace the existing contract that has been in place since 2007.

Benenden Health, the mutual healthcare provider, is running an alternative service to NHS 111. Benenden Health provides a 24 Hour GP Advice Line to its members. The phone-line is serviced by qualified, UK-based GPs and even accepts calls from around the world, giving medical advice to Benenden health members who are abroad at the time.

Health Education England (HEE) has announced the Government’s Mandate to Health Education England, on NHS staff training and education that sets out plans for education and training for all NHS staff. It includes a target for 50% of all medical students to become GPs as part of a rebalance England’s healthcare towards a more community based system.

MedicX Fund, the specialist primary care infrastructure investor in modern, purpose-built, primary healthcare properties in the United Kingdom, has completed the acquisition of a portfolio of seven operational, fully let primary care medical centres, together with seven further properties under construction. The purchase is by way of a corporate acquisition of GPG No.5 Limited for a cash consideration of £10m including transaction costs of £0.8m and the assumption of existing debt facilities of £34.7m of which £21.4m is drawn. The completion of the development of the seven properties under construction will be managed by General Practice Investment Corporation Limited (GPI), a third party developer of primary care properties, which will retain all of the development and construction risk. MedicX has also negotiated a framework agreement with GPI giving the fund first right to forward fund future projects adding £35m to the fund’s pipeline. The completed properties within the acquired portfolio are on average less than one year old whilst the total acquired portfolio benefits from 38% RPI indexed leases with a further 5% subject to fixed uplifts, the balance being subject to open market reviews. This portfolio of assets is spread throughout England and increases MedicX fund’s total property portfolio to 121 properties. Of these 109 are complete and operational and 12 are under construction. The fund’s total annualised rent roll for all properties following the acquisition increases to £27.9m from £25.1m with the portfolio as a whole having an average unexpired lease term of 17.2 years as at 24 May 2013.

Almost half of GPs (48%) say they have seen waiting lists for NHS hospital referrals rise, and two in 41% say they have seen an increase in the number of patients asking about self-pay treatment options compared to a year ago, suggesting that many patients are turning to private self-pay treatment options as a response to increasing hospital waiting times. Younger GPs are more likely than older GPs to agree that they have seen an increase in the number of patients turning to self-pay treatment options. Spire Healthcare which commissioned the survey say the results suggest that GPs have faith in the private healthcare sector. 50% of GPs think the private sector offers good value for money for patients who seek self-pay treatment or use their private medical insurance. Dr Jean-Jacques de Gorter, clinical services director at Spire Healthcare, said: Our findings highlight that public attitudes towards private healthcare are changing. Patients are taking greater responsibility for their health and wellbeing and this is freeing up NHS resources where they are most needed.

GP representatives have hit back at criticism from the Secretary of State for Health over pressure on NHS A&E services. In a speech last month Jeremy Hunt MP blamed changes to GP working hours for an extra four million people going to hospital each year. The changes introduced by the Labour government in 2004 allowed doctors to opt out of out of hours care for a reduction in salary.

GPs and other primary care staff need empowerment to lead a more proactive approach to prevention and help people remain healthy into old age, according to a new report written by the Nuffield Trust.