Extra funding for General Practice is much needed and it is is great when they start paying for extra work dumped out of hospital. But incentives like paying £20 per advice and guidance request is just plain dumb.
The NHS cannot afford for GPs to be forced to make more referrals in order to earn income. Instead, we want the *minimum* number of high-quality referrals to meet patients’ needs.
The reason the NHS is cost effective is because it is paid to keep people well, not do more operations. The ideal incentive would be tied to an assessment of how healthy people are. But health is so dependent on employment, housing, education (etc) that the contribution of the NHS would be hard to separate.
Clinicians are often having to spend ridiculous amounts of time working out how to code the work they do (to get paid) in addition to actually doing the work.
The NHS needs adequate baseline funding to do the work needed and to only pay incentives for things that reduce total NHS workload. Doing more contraception and immunisation prevents future work and reduces overall spend. Doing more referrals does not reduce the total number of referrals.
We want evidence based, realistic, long-term funding, not quick-fix schemes that make things worse.