GPs paid bonuses for creating ‘death lists’
In a controversial NHS cost-cutting exercise to reduce the number of people dying in hospitals, GPs are being paid bonuses to put elderly patients on ‘death lists.’
In exchange for drawing up ‘end-of-life advanced care plans’ doctors are being paid £50 for each patient.
The payments are supposed to provide an incentive for doctors to discuss with their elderly and seriously ill patients their end-of-life preferences.
Pilot
Ipswich and East Suffolk Clinical Commissioning Group (CCG) piloted the scheme from July 2011 to September 2013.
Doctors at 41 practices in Ipswich and East Suffolk were paid £50 for each care home patient they signed up to an end-of-life plan.
GPs asked their patients where they would like to die, whether they wished to be resuscitated, and what drugs they wanted in their final hours.
Better death
The creators of the initiative justify it by saying the main aim is to give patients a better death.
But there is great concern that the scheme could result in patients not receiving the life-saving treatment they need.
‘Why should a GP be paid for this conversation, as opposed to any other?’ said retired geriatrician Dr Gillian Craig.
She added: ‘I feel doctors are paid very well and there should be no extra payments. Anything else is open to abuse and misuse.’
‘A doctor may not realise that, while the person appears to be dying, they actually have a reversible condition.’
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