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Smartphone GP app service will divert funding from most needy, warns practice

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1045 (Published 05 March 2018) Cite this as: BMJ 2018;360:k1045

Re: Smartphone GP app service will divert funding from most needy, warns practice

Matthew Noble’s statement about the difference in funding for GP surgeries for a young, male patient compared to an elderly, female patient is misleading.

What he fails to point out is that the apparently large difference in weighting given to patients of different ages is “normalised” by comparing the practice population to that of the wider area in which it operates. The calculation is complex but were our practice to lose 100 of our young patients the total annual reduction in our funding would be just £200 less than if we lost 100 of our most elderly patients. This is a far cry from the sixfold difference suggested.

When such practices further select patients within the different age bands to avoid those with complex health problems (avoiding complex mental illnesses, drug misuse, pregnancy and so on), the practices left treating these patients are further destabilised. The current funding model requires practices to have patients on their list who do not consult often to balance the otherwise inadequate funding for the complex patients who need more care.

Competing interests: No competing interests

13 March 2018
Sarah Williams
GP
Hackney