Doctors get bonuses for extra ops

Complicated ops may be less financially rewarding, says the BMA

A scheme that rewards doctors for seeing extra patients is to be piloted across NHS trusts.

The initiative will offer financial rewards to doctors, and is the latest government bid to slash waiting times.

Sites already testing the scheme pay surgeons a minimum of £100 per extra operation performed.

But the British Medical Association has said it is concerned the scheme might discourage doctors from doing carrying out complex procedures.

Patients want quality and safety before numbers and speed Dr Paul Miller, chairman of the BMA's consultants committee

Hospitals taking part in the "Fee for Services" scheme will be able to offer additional payments to medical staff who deliver extra work over and above their usual workload during their normal working hours.

One hospital in the West Country intends to use the scheme to treat local heart patients who would otherwise have been sent elsewhere in the country to be treated.

Doctors within the hospital will be offered the money that would have been spent on sending the patients to other hospitals.

The government claims if this happens in all 32 trusts taking part in the pilot it will mean 8,000 additional operations and 6,000 outpatient consultations can be provided.

The three models Extended reward scheme - pay for agreed extra work Benchmark scheme - pay for more than agreed benchmark level of work Treatment centre approach - higher pay for high achievers who work in a radically different way

The scheme will test three different models, each aimed at rewarding those doing the most to "increase efficiency and reduce waiting times".

The pilots will cover a range of treatments, including orthopaedics, ophthalmology and general surgery.

Their success will by judged in early 2005, when the government will decide whether to roll out the schemes more widely.

Health Minister John Hutton said: "New NHS pay contracts are already incentivising front-line NHS staff to become more and more innovative in improving patient care.

"The Fee for Service scheme builds on these reforms by giving consultants and other NHS staff even stronger incentives to ensure that more patients are treated, more quickly."

Concerns

But Dr Paul Miller, chairman of the BMA's consultants committee said: "It's odd that the government is piloting a scheme like this when many hospitals still haven't implemented new contracts that pay consultants for all the work they do.

"We're concerned that the way the system will work might be too simplistic and we will be examining the details carefully.

"If doctors are paid a fixed amount for each procedure, they're effectively being pressured into taking on simple operations rather than treating patients with more complicated conditions.

"Patients want quality and safety before numbers and speed," he said.