Incentives for GPs to cut emergency admissions could lead to “target culture,” warns GP leader

BMJ 2013; 346 doi: (Published 15 January 2013) Cite this as: BMJ 2013;346:f312
  1. Gareth Iacobucci
  1. 1BMJ

A plan to tie a proportion of the funding for clinical commissioning groups (CCGs) to reductions in “avoidable” admissions to hospital of patients with long term conditions risks distorting priorities and creating a new “target culture,” a senior doctors’ leader has warned.

A quarter of the new “quality premium” incentive payment paid to new commissioning organisations in England from 2014-15 would depend on their achieving a reduction or no change in emergency admissions for specific conditions between 2013-14 and 2014-15, says draft guidance from the NHS Commissioning Board.1

The money allocated to the premium, proposed as part of the UK government’s changes to healthcare,2 will be determined after parliament sets regulations in the next few months. It will be paid on top of each commissioning group’s main financial allocation for 2014-15 and the running costs allowance of £25 (€30; $40) per head …

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