You are reading a single comment by @Chalfie and its replies.
Click here to read the full conversation.
-
Yeah, we were looking at disease counts in lambeth with someone. They took their carer hat off, put on their CCG hat and asked "which of these people are lambeth residents. They're the ones we pay for"./ of as harsh as that, but words to that.
Chalfie-
"Commissioning" is so much bullshit and patient confidentialty/Caldicott seems to obstruct patients who clearly really need help/intervention being flagged as such.
I've seen records suggesting there are individual patients with 100's of A&E attendances in a year who seem to be using it as a hostel/accommodation and never does a CCG actually have enough info to query the £1000's of cost they are paying for or put them in the place they need to be.
dubtap
There are huge opportunities to do this but under the current adversarial contracting model of purchaser vs. provider there are no incentives for change to happen.
Providers find every way they can to record and be paid for as much activity as possible and commissioners try to evade payment for anything they can claim is someone else's responsibility.
The transactional costs of this system are mind-boggling and the negotiation of contracts for one provider take literally 1000's of man hours to conclude. We just agreed our main 15-16 contract for Apr15-Mar16 in November. Still haven't signed the other £300m worth.