Northdoc, the GP Company providing the D doc Urgent GP out of Hours service is set to increase consultation fees by €5 for OOH consultations and €10 for urgent home visits – GMS Medical card holders are not affected.
A recent meeting of the board of Northdoc decided to increase private fees. Consultation fees will increase from €60 (unchanged since 2006) to €65.00 for patients attending the DDoc centres and the home visit fee will increase from €80 to €90. About 5% of home visits are to private patients.
Private fees represent approximately 25 % of Northdoc income with GMS Medical Cards/ HSE income providing 75%.
Just under 100 thousand people in North Dublin contacted the service last year and of these, seventy thousand had direct face to face GP consultations.
GP referral rates to A&E were in the region of 7% of all consultations.
GPs arrange less than 1% of patients to be transferred to A & E by ambulance.
Northdoc Medical Director Dr Mel Bates said “In the absence of a restoration of the FEMPI cuts, which have had a significant impact on the service in terms of the number of doctors that can be provided this increase is inevitable while we wait on the announced reversal of the financial emergency measures (FEMPI) brought in during the financial crisis.”
The HSE rely on Northdoc to provide medical governance and oversight to ensure the best quality of care is provided in the DDoc service. There is a cost to this and the HSE make no contribution to it. In order to provide this the company rely entirely on private fees. There are significant costs in terms of clinical oversight.”
Northdoc outperformed 15 UK and Irish Out of Hours Urgent GP services under clinical learning and continuous improvement of patient safety throughout the organisation. The studies were carried out by the MPS the medical protection society U.K. (For more see here)
Dr Mel Bates said “Our focus is on patient safety – This depends on the quality of our GPs and the ways in which we provide support. We have a comprehensive doctors’ handbook which covers challenges specific to out of hours where normal daytime supports are absent. We also have an anonymized audit system for clinical notes (Clinical Notes Assessment) where we can audit and feedback to GPs on the standard of their clinical notes”.
MPS also noted that Northdoc were the first company in Ireland to get the International Social Enterprise Mark for their work and member GP services, especially with marginal groups such as the homeless in North Dublin.
Dr Bates said that it was with great reluctance that the new fees were being introduced but in order to maintain the quality of the service and in the absence of FEMPI reversals the company had no choice.