Are Care plans for patients worth it???

Care Plans
Recent discussions have confirmed what I have already written.  I did not mention that another negative is the duplication in entering information in the Plans and the Team Care plans..
I explored the reasons for not wanting to set them up and although I did not specifically mention it, one of the major negatives is the total artificiality of the whole exercise  You go through the exercise of creating a plan and then explaining it.  The patients even sign to say they agree.  But they just see it as a thing the doctor has to do.
They rarely reappear and trying to track for plan adherence is a nightmare.  So the question has to be asked if any plan helps to improve patient care over what is done now without any plans.
The patient appears and you look for what is the chronic disease or diseases they have and then see if they need any follow-up.  Then you arrange it.  It seems to work well but is dependant on the patient coming to see the doctor.  There is no pre-emptive care and this is what care Plans attempt to do.  The whole idea is to construct a planned management approach which should optimise care of any chronic disease.
Follow up could be still done by a receptionist who would do it the same as the ideal followup that should be done for test results / referrals / x-rays .  it would work.  You could say that the patient has been referred for podiatrist.  Have they gone (is there a letter) if not follow it up.  But very labour intensive 
A Professor Georgeff has evolved web based system.  But again it has to be done by staff.  The question is whether or not you are paying a wage just to see if patients look after themselves. Is it worth it??  At the moment no because we are paid for sickness and not patient wellness.  Plans and adherence will be looked at in another light if we are paid on wellness results.  Sounds good but then we focus on adherence and not the patient.