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FIRST ACCESS to Nadeem Walayat’s Analysis and Trend Forecasts

Sheffield NHS GP Post Code Lottery Map, The Best and Worst Ranked Surgeries

Local / Sheffield Nov 06, 2010 - 12:10 PM GMT

By: N_Walayat

Local

Best Financial Markets Analysis ArticleBritain's post code lottery in health services manifests itself in the failure of GP's and PCT's to equally prescribe life saving and prolonging medicines and treatments regardless of where patients live. The greatest disparity in health care provision observed is that of between affluent and deprived areas of the country where life expectancy can differ by as much as 14 years within just a couple of miles distance as a consequence of real GP performance against NHS propaganda of uniform delivery that this article seeks to put the spot light on for the city of Sheffield.


The Department of Health funded UK GP Patient Survey 2009-10 recently released results of more than 5.5 million detailed questionnaires sent out to NHS GP patients across England of which 2.17 million were returned. For the City of Sheffield a total of 65,339 questionnaires were sent out to the patients of Sheffield's 92 GP surgeries of which 27,380 were returned from which detailed results were compiled as listed in the table at the end of this article for the overall level of satisfaction at the quality of health care received for all of Sheffield's GP surgeries.

Of Sheffield's 92 GP surgeries, 24 or 26% managed to achieve a rating of 95% or higher, which given the importance of health care should be the minimum goal for ALL GP surgeries. Next 43 (46%) of Sheffield GP surgeries managed to attain a patient satisfaction level of 90-94% of their patients, 19 (20%) between 85% and 89%, followed by 6 GP surgeries scraping the bottom of the barrel, notably Darnall Community Health coming in at an abysmally poor bottom rank of just 68%.

The following map shows Sheffield's Top 15 and Bottom 15 GP surgeries as ranked by Sheffield patients. The results show that Sheffield's best performing GP surgeries tend to cluster in the affluent areas of the city, which is reflective of the 'post code lottery' where those that reside in the affluent wards due to more likely being professionals are able to demand a better quality of NHS GP services than those that tend to reside in the deprived wards who tend to suffer in silence as for what passes for health care provision which plays a significant part in contributing to a more than 14 YEAR GAP IN LIFE EXPECTANCY between peoples living just a few miles distance from one another, which has been commented upon in the past by the Sheffield MP and Liberal Democrat Leader Nick Clegg :

"It is an outrage that social mobility has slowed, not increased, under the Blair-Brown years. It is an outrage that in Sheffield, where I’m an MP, life expectancy in the poorest wards is a full 14 years below the life expectancy of those living in the wealthiest wards. Your life chances are now set by the circumstances of your birth as never before."

The map also suggests that patients of some surgeries have the opportunity to change to nearby better performing GP surgeries, though the old boys network will probably prevent you from doing so.

Patients across England can check the patient rating of their GP Surgeries here http://results.gp-patient.co.uk/report/main.aspx.

Patient Choice

The 13 year Labour government has come and gone and still PCT's such as the Sheffield NHS sit twiddling their thumbs with a continuing series of costly patient consultations rather than acting to allow patients to be able to choose to register with any GP, as patients remain locked into their local GP surgeries regardless of the huge disparity in actual health care provision as experienced by patients and as demonstrated by the UK GP Patient survey. Recently, the National Audit Office Report painted a picture of a widening gap in life expectancy between affluent and deprived areas of the country of more than 10 years as a consequence of GP's in deprived areas effectively failing to do their jobs as the report implies GP's ignore the symptoms of a large section of their patients which results in less resources being plowed into high disease prevalence deprived areas in favour of more resources being directed to low disease prevalence affluent areas.

Department of Health - Tackling inequalities in life expectancy in areas with the worst health and deprivation

GP's provide the main access point to healthcare and are crucial to providing care to the neediest groups. The main lever for rewarding their activity is the Quality and Outcomes Framework which was introduced in 2004. However, it does not provide enough of an incentive to target GPs attention on the neediest groups. GPs can achieve full payment of the additional income available under this framework without covering the entire practice population and as a result the hardest to reach and most in need groups may not be helped through this framework. In addition, until 2009, payments were scaled in such a way that areas with high disease prevalence, often concentrated in deprived areas, received less remuneration per patient than those with low prevalence, and payments to practices did not fully reflect the level of illness in the practice population. By 2011, payments are expected to fully reflect the level of need with consequent redistribution of payments between practices.

However, the new Coalition Government was apparently so impressed by the performance of the NHS Primary Care Trusts (PCT's) that as part of its cost cutting austerity plan it intends to scrap ALL PCT's in favour of GP Consortia's directly managing patient treatment commissioning (the process could take 2-3 years to implement). This means Sheffield NHS PCT who's achievements include employing 400 bureaucrats in a new multi-million pound headquarters is destined to disappear from Sheffield's health landscape.

However whilst the media has been focused on the news of scrapping of all NHS PCT's, the flip side of the coin lies in the consolidation of GP practices into GP consortiums in an attempt to introduce real competition between surgeries for patients which means that the less performing GP surgeries in cities such as Sheffield could disappear as they will be unable to compete for patients in a more market orientated value for money environment due to their inability to provide health services to the satisfaction of a large % of their patients.

The anticipated changes are set against the current system which contrary to what the population believes GP's are Independant PRIVATE contractors to the NHS WITHOUT COMPETITION.

The NHS Health Credit Card

The NHS post code lottery which excludes millions from the best health care on offer can only be ended if there is real patient choice, not only for GP's but also hospitals and other health institutions right across the country where treatment is sought which requires real reform of the whole NHS health care system from diagnosis to treatment of all patients . An important element would be to place the power to purchase healthcare into the hands of the patients by means of an NHS Health Credit Card system, that enables patients to purchase health services from any GP practice or hospital regardless of whether it falls under the NHS umbrella or is fully private, so that both patients and health practitioners would be fully aware of the financial transaction involved in the purchase of the health service, which is set against the current system where patients are made to feel that they may be wasting the GP's time so are easily put off by the practiced dismissive attitude of most GP's during initial consultations, which means the medical condition of patients reaches a far more serious state and this proved more costly for the NHS to treat.

Patients would have a choice of covered core treatments for illnesses or injuries, where they would have the option of paying to top up treatments with their own money depending on the institution that they seek to purchase treatment from, or for other extra's including IVF etc. This would have the effect of reducing the cost of the NHS whilst introducing greater efficiency into the NHS as the majority of patients would only choose those health service institutions that are ranked as delivering a good service. The NHS Health credit card would revolutionise the way healthcare is delivered in the UK, much as supermarkets revolutionised food delivery and choice during the 1980's, as heath supermarkets would spring up all across the country that would maximise efficiency and standardise quality of service delivery as they competed to offer a wider range of health services than anything a bureaucratic top down health care system could ever hope to provide.

The health care credit card system could be further enhanced by workers directly contributing to their health care plans that they can claim upon to purchase 'extra' services at a later date, much as workers today contribute into private pension schemes.

The impact of this would be to greatly REDUCE the cost to taxpayers whilst at the same time delivering better health services, a win, win outcome for the people of Britain as opposed the current system of an out of control unproductive £120 billion National Health Service that attempts to mask failure to deliver with phony statistics and propaganda of a "free for all service" that does not match real patient experience.

Results For All 92 Sheffield GP Surgeries Ranked in Order of Patient Overall Satisfaction of Care Received

Data Source - http://results.gp-patient.co.uk/report/main.aspx

Source:http://www.marketoracle.co.uk/Article24084.html

By Nadeem Walayat

http://www.marketoracle.co.uk

Copyright © 2005-10 Marketoracle.co.uk (Market Oracle Ltd). All rights reserved.

Nadeem Walayat has over 20 years experience of trading derivatives, portfolio management and analysing the financial markets, including one of few who both anticipated and Beat the 1987 Crash. Nadeem's forward looking analysis specialises on UK inflation, economy, interest rates and the housing market and he is the author of the NEW Inflation Mega-Trend ebook that can be downloaded for Free. Nadeem is the Editor of The Market Oracle, a FREE Daily Financial Markets Analysis & Forecasting online publication. We present in-depth analysis from over 500 experienced analysts on a range of views of the probable direction of the financial markets. Thus enabling our readers to arrive at an informed opinion on future market direction. http://www.marketoracle.co.uk

Disclaimer: The above is a matter of opinion provided for general information purposes only and is not intended as investment advice. Information and analysis above are derived from sources and utilising methods believed to be reliable, but we cannot accept responsibility for any trading losses you may incur as a result of this analysis. Individuals should consult with their personal financial advisors before engaging in any trading activities.

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