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EDUCATION AND DEBATE: Linda Gask Role of specialists in common chronic diseases BMJ 2005; 330: 651-653 [Full text]

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Funding follow up key to long term specialist care

jon norman   (19 March 2005)

Funding follow up key to long term specialist care 19 March 2005
jon norman, pain fellow south manchesteruniversity hospitals trust, m23 9lt Send response to journal: Re: Funding follow up key to long term specialist care	EDITOR- Linda Gask states that consultants do not manage most patients with chronic diseases even though they should have a key role. She argues that the current NHS organisational structure is largely to blame. The current service level agreement means that PCT’s pay hospitals for new patient referral and per procedure. There is no fee for follow-up or variations in new patient fee to take into account the chronic nature of a condition. To preserve current levels of service hospital clinics have to maintain an active discharge policy to stop clinics becoming overwhelmed with long term non-funded follow-ups. This can reduce job satisfaction in and patient satisfaction with hospital care. New funding arrangements will need to address this issue for secondary as well as primary care to achieve a better service for patients with chronic diseases. Jon Norman pain fellow South Manchester University Hospitals Trust, M23 9LT j.norman@smuht.nwest.nhs.uk Competing interests: None declared 1 Gask L. Role of specialists in common chronic diseases. BMJ 2005:330:651-3. Competing interests: None declared