Playing Devils Advocate - Are GP's financially incentivised to make a T2D diagnosis?

P

pjgtech

Well-Known Member
Relationship to Diabetes
Type 2
As per the title, just playing devils advocate, but interested in opinions.
I read ages ago, sorry cannot remember where, that a GP surgery gets (presumably Govt) funding to the tune of £5k for every T2D patient that they diagnose.
So, does this then lead to maybe to some cases being diagnosed when in fact they are borderline, because the practice would benefit financially? If so, is this a problem?

NB: I am certainly NOT stating that this was a factor in my case, I am overweight, I do have contributing factors, I am T2D and needed treatment, and I am grateful to my GP and the practice for all the support, info, medication, etc that they have provided for me.

I would assume that if this is true, (no idea if it is) then GP practices may also receive funding for other diagnosis's too.
I have to hold my hands up and say that I have no real knowledge of how GP practices are funded, so looking forward to finding out.
 
pjgtech said:
So, does this then lead to maybe to some cases being diagnosed when in fact they are borderline, because the practice would benefit financially?
Click to expand...
Perhaps. I'd guess whatever extra money they get would mostly only cover what they're then required to offer the patients (at least annual checks and often medications and other support). I'd guess the money would be stuck to the formal criterion of HbA1c over 48 anyway, so I doubt there's that much borderline anyway?

 
Bruce, thanx for the link, just read it cheers.
Why am I not surprised that the first sentence states "The funding a general practice receives depends on a complex mix of different income streams." Complex, yeah, course it is, wouldn't want to make it simple now would we!
 
I was tested without my knowledge in 2014 and had a hba1c of 40. I assumed my blood was tested regularly after that. I was on vaguely annual reviews as I had high blood pressure but last saw a GP about it 2009. The reviews were always taking blood and blood pressure sometimes weighing and occasional height. I used to give a pee sample but that stopped years ago. I was called in to see a hcp as my cholesterol crept up and given the statins hard sell. I asked was I being tested for diabetes and told no. Asked for diabetes test and had reading of 69 four weeks later 64. The person concerned said they were trying to persuade partners to test all hypertensive patients fir diabetes. I am overweight and now retired. If a diabetes test was appropriate in 2014 I don't know who thought no point after that date. I've noticed our surgery now offers check ups for patients 50 to 75 and I regret not requesting one before. I am still within that range. I've never had a medical as an adult. I suspect the current rules don't adequately reward GPs for people found who are prediabetic or below. As a non medic it seems to me if you are taking blood as a health review add the hba1c. I have been slightly jealous of the newbies joining prediabetic as a check up. There must be a huge saving if they can reduce their blood sugar and improve their health.
 
Bruce Stephens said:
I'd guess whatever extra money they get would mostly only cover what they're then required to offer the patients (at least annual checks and often medications and other support). I'd guess the money would be stuck to the formal criterion of HbA1c over 48 anyway
Click to expand...

That would be my thinking.

We do generally need a lot more looking after that nonnys - with annual checks, possible dents into the prescription budget, pharmacy reviews, heart and cholesterol checkups (and possible meds) etc.

In a sense it’s useful that there’s an ‘at risk of diabetes’ warning level, before you get to the 2-result over 47mmol/mol diagnostic cut off - so overall BG levels have often been ramping-up before the diagnosis is confirmed.
 
pjgtech said:
As per the title, just playing devils advocate, but interested in opinions.
I read ages ago, sorry cannot remember where, that a GP surgery gets (presumably Govt) funding to the tune of £5k for every T2D patient that they diagnose.
So, does this then lead to maybe to some cases being diagnosed when in fact they are borderline, because the practice would benefit financially? If so, is this a problem?

NB: I am certainly NOT stating that this was a factor in my case, I am overweight, I do have contributing factors, I am T2D and needed treatment, and I am grateful to my GP and the practice for all the support, info, medication, etc that they have provided for me.

I would assume that if this is true, (no idea if it is) then GP practices may also receive funding for other diagnosis's too.
I have to hold my hands up and say that I have no real knowledge of how GP practices are funded, so looking forward to finding out.
Click to expand...
It's mostly been suggested in the past that the NHS couldn't actually afford to diagnose all the Type 2s there are out there. Under-diagnosis rather than over- diagnosis is probably more of a problem. And under spending on Type 2 as well. Diabetes UK ran an information campaign about this issue, undiagnosed diabetes, called 'The Silent Assassin' about 15 years ago.
 
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