Primary Care contracts are very different to other contracts within the NHS as the GPs are often self employed partners who are contracted for services by the PCT and a lot of their income is target based. They are given a high percentage of costs for staff contracted the practice. They also facilitate and liaise with other NHS employees eg Midwifes, Health Visitors, Psychology services etc. They normally operate service level agreements to provide a service to the patients registered to their service. They are also required to take on patients that are difficult to deal with on a rota basis.
As I see it pros of this service:
GP who has a full medical history and knowledge of patients (including allergies) and hopefully family history, which could make them more alert to certain conditions.
Out of hour’s service for emergencies including home visits, where medically necessary.
Continuity of care
Would these other agencies be willing to take on ‘expensive’ patients eg elderly those requiring expensive medication.
Cons
Having to fit in with surgery appointment system not always conducive to working live.
Not always getting to see a doctor of your choice
Some GPs will do anything to avoid a home visit and there are times when this is necessary.
Waiting around for appointments for an unacceptable amount of time
I’m sure there is a lot more that I could add if I gave it more thought but where I find these changes worrying in the increased amount of privatisation and widening of services are the possible problems that can occur where a full medical history is not known.
Would they only offer services that suit leaving the NHS to pick up the less profitable services
Would they take on difficult and expensive patients?
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