Medical Centre

The NHS prescription charge in England is currently £8.60 per item. At this level, many commonly prescribed drugs will cost less than the prescription charge and so some NHS patients may occasionally ask if they can have a private prescription rather than an NHS prescription. In the past, some GPs have been advised that they could issue both an NHS FP10 and a private prescription, and let the patient decide which to use. But the British Medical Association's General Practice Committee has obtained legal advice that said under the current primary care contract, GPs in England may not issue a private prescription alongside or as an alternative to an NHS FP10 prescription. In any consultation where a GP needs to issue an FP10, the concurrent issue of a private prescription would be a breach of NHS regulations. The issuing of a private prescription in such circumstances could also be seen as an attempt to deprive the NHS of the funds it would receive from the prescription charge. ...

The NHS is currently aiming to develop a new capitation-based formula for funding general practices in England. My view is that a revised formula won’t address the fundamental problem with the current method of funding primary care: the disconnect between workload and funding. All the new formula will do – no matter how well-designed - is shuffle money between general practices. Some practices will gain substantial sums, some will lose substantial sums; but most practices will see no major changes in their funding. Capitation-based formulas for general practices are a 20th century solution that the government is trying to continue to use in the 21st century. We need to move away from a capitation-based funding model to one based on actual workload. Under such a model, any work done by general practices – whether generated through government policy, patient demand or transfer of work from specialist settings into the community – would be paid for at its full cost. There would then be n...

A recent study from my research group published in JRSM Open examined why some children do not attend their hospital outpatient appointments. The study found that the commonest reason for non-attendance is unawareness of the appointment due to incorrect contact details being held by the hospital. Potential strategies for reducing non-attendance at paediatric clinics include developing a confirmation or reminder system and improved communication with parents.

A recent study from my research group published in JRSM Open aimed to identify ideas for patient safety monitoring strategies that could be used in primary care. People who took part in the survey offered 188 suggestions for monitoring patient safety in primary care. The content analysis revealed that these could be condensed into 24 different future monitoring strategies with varying levels of support. Most commonly, respondents supported the suggestion that patient safety can only be monitored effectively in primary care with greater levels of staffing or with additional resources. About one-third of all responses were recommendations for strategies which addressed monitoring of the individual in the clinical practice environment (e.g. GP, practice nurse) to improve safety. There was a clear need for more staff and resource to encourage better safety monitoring. Respondents recommended the dissemination of specific information for monitoring patient safety such as distributing the ...