Wednesday, 16 May 2012

Recycling the QraP.

One thing the NHS does really well is recycling. We are not talking about the recycling of reusable resources in short supply in order to maintain their future availability for the NHS does not do any such useful recycling.

Instead the NHS does the recycling of the same old ideas that an eleven year old child could probably work out why they will not work or deliver anything useful. Unfortunately a lot of people in healthcare are not as bright as an eleven year and so look what piece of recycling has gone into this year's pile of QraP.

QraP is the name we dedicated healthcare professionals here at ND Central have for the QP indicators in the nGMS contract QOF points and stands for Quality and Productivity but equates to neither of these 2 words in reality.

Last year we played the let us waste time and interfere with well controlled patients' medications as part of QraPing and this year it is a well roasted chestnut that is now blacked and charred beyond all recognition as the QraP idea. Have a look at QraP indicators QP 12-14.

So once again GPs instead of treating patients are being asked to stare into dark black holes which we have stared into many, many times before and have achieved nothing by doing so. Can you remember Public Health lectures and A&E lectures as medical students and in any specialty since asking the same question how do we reduce admissions? Deja vu?

The purpose is in the first paragraph and says they "aim to reduce avoidable Accident and Emergency attendances". In your dreams.

All accidents are potentially avoidable but for some reason they still happen. A lot of illness is avoidable but still happens. And the reasons people still attend A&E are still the same as when we were at grunt school and include some of the following excuses/reasons and amongst them are the following inalienable rights:

1) I can.
2) It is free.
3) There is no sanction for (NHS Choice ®™) choosing to do so.
4) It is closer to home.
5) I rang my GP who wouldn't see me that minute so I came here instead.

and so on.

So if you can't get to see a GP and find you have to go to A&E to be seen do you think that the diversion of GPs away from surgery work to stare at pretty, pretty practice data on A&E attendances (QP 12 monthly) and then have a GP group love and hug in with doctors from other practices to do the same (QP 13) in order to produce reports and improvement plans to reduce avoidable attendances (QP 14) might have anything to do with these attendances?

Doctors wasting more time QraPing and staring into black holes will not improve patient care it is simply trying to save money by wasting time and as a result compounding the problem they are meant to be solving. GPs do not send the vast majority of patients to A&E it is patient NHS Choice ®™.

A far simpler method would be a flat charge for attending A&E payable in advance and refundable if you have a genuine Accident or Emergency lets say £50. If you have a heart attack or a broken bone you get your £ 50 back.

If you are drunk or have a sore throat you don't. A few £ 50 a time Friday night attendences and we suspect that this alone would make people think twice whereas now they don't give a damn (and that is being polite). But we hear you say the NHS is free at the point of access and we don't want to be charging people for using A&E, do we?

Are we not already doing this already? Yes we are and if you have a Road Traffic Accident you may be sent a bill which you normally pass onto your insurers.

So maybe if you attend A&E and do not wait to be seen, or it is not a real accident or emergency the NHS could do as it does to the sufferer of a Road Traffic "Accident" and send them a bill? That is perfectly legal and within the current NHS "market" ethos. It would only require a small change to legislation and should not hurt anyone who is genuinely ill.

Praise be to the Party for ensuring that when it comes to increasing access to GPs this is best done by taking them away from their surgeries and sending them all for one huge great collective QraP (QP 12-14).

Haven't we all done this before many times and it makes bugger all difference?

1 comment:

Can't think of a name said...

I can remember desperately trying to get a relative into A&E. If we'd had to find £50 up front, I'd have had to leave a very ill man lying on the floor for half an hour while I went to a cashpoint. We don't all carry lots of money around and £50 is nearly a whole week's carers allowance.