I have been elected as chair of the BMA GPs committee at a critical moment for general practice. We face enormous challenges, and I want to work with all members to shape the future of our profession and improve patient care.
This is not an easy time to be a GP. General practice is facing a year-on-year reduction in investment as a proportion of total NHS spend. But at the same time, we are being expected to take on significant extra work. And while international research continues to confirm the extraordinarily high quality of care UK GPs provide, we are unjustly subject to political and media assaults and erroneously blamed for failings in other parts of the system.
This comes as GPs in England are forced to deal with the impact of the imposed changes to their contract. We all have our own experiences of this, but what the BMA needs is a bigger picture of its impact. So we have emailed all English GPs a survey to get a better idea.
The survey will only take a few minutes to fill in, but it covers some vitally important areas. It asks about workload, morale, funding and expenses. It also covers the levels of engagement with clinical commissioning groups, the impact of the changes to the QOF (quality and outcomes framework), and GPs’ view of and participation in the new directed enhanced services.
We have kept the survey deliberately short and simple, but you can tell us in more detail about these issues in the comments section below.
The answers to the survey, due in a few weeks, will inform the negotiations just beginning for the 2014/15 contract.
Furthermore, we can see that demographic changes and moving care into the community will create new demands for general practice. We know, and we must make the government know, that these challenges cannot be tackled by simply piling more work onto general practice, at a time when GPs are working above capacity.
So in the autumn, we plan to publish an outline vision of how general practice can be supported and developed to help the NHS meet its many challenges. We will need your views to help us create the best possible blueprint.
Work with us, and we will do all that we can to restore pride to our great profession and give patients the high quality care they deserve.
Chaand Nagpaul is chair of the BMA GPs committee
What has been the impact of the contract imposition and QOF changes on you? Tell us in the comments section below
This years' QOF changes have really sapped my morale. At least with the original QOF the evidence base was sound, but now the emphasis is not on evidence but political short-termism. In fact there is more evidence against the current new QOF targets than for them(Dementia screening, Remote Care, Risk Profiling...). very disappointing
QOF has become a laughing stock. It is so confusing and has been distorted beyond recognition from its original purpose. Unfortunately our iincome and ability to 'keep the lights on' is now so entwined with these DESs, LESs and QOF that we have little choice but to partake in this tick-boxing fiasco. It's a shame as at 40+ years of age I should be developing my role as an experienced GP and instead I find myself thinking about emigrating......
We have signed up to the 4 new enhanced services but I don't see we have a "cat in hells" chance of achieving the targets. Our QOF will also be inevitably down. We are spending hours at the moment chasing the QIPP targets in QOF and I don't think we have a hope of making much difference to patients or the CCG finances as a result. It feels more and more everyday as though we are living in Alice in Wonderland chasing everymore unreachable targets. Morale is at an all time low and I think it is due to the fact that we aren't able to do what most of us went into medicine to achieve and we are set unrealistic goals (financial and clinical) which gives us all a sense of failure. Add to this the increasing public expectation and the increased number of complaints it feels we have a constant uphill battle where it is diffuicult to see much success. I am now spending 60-70 hours per week working and it feels as though I have much less free time than we were doing all our own on-call work. This level of workload for us all isn't safe and it isn't sustainable.
Ask any GP and they think we are being set up to fail by this government with MPs noses in the trough with their private health care businesses, set to do well.
Some of the new QOF Thresholds are actively dangerous for a small section of society with the poorest health. We want patients to work with us, these thresholds drive a wedge between achieving monetary targets and providing high levels of patient care at a pace and level to suit those patients.
This fiasco is driving good GPs into retirement and a lot of our younger doctors overseas. If one doctor does cost Â£250k to train, how much will it cost our health economy for short-sighted gains.
I do welcome removal of Cholesterol targets as evidence is poor, removal of GPPAQ's and biopsychosocial feedbacks is good and it doesn't change the clinical picture
Looking at QP, I am please they are gone but replaced with equally time consuming admission avoidance DES. Valuable Doctor time lost planning for these things in meetings? I would suggest change of name like Caring of patient in their home DES.
Funding to General practice is extremely poor. We get less per patient in a whole year that A&E gets for one admission. Ii think GPC needs to take that with Govt. If we had more resources i.e, doubling of our per patient core funding, we could afford several more GP's and open for longer hours. Keeping practice open for 2 days more will cost a lot in the doctor time, staff time, electric and heating costs.
I do sympathize with your role and difficulty as GPC chairman, it is very hard negotiating with Govt that is hell bent on destroying a precious resource. as Alan stated above, most of the MP's have a vested interest in private companies.
My concern is that general practice is really struggling, with ever increasing workload and low morale, as comments above, newly trained doctor would prefer to go overseas in search of work-life balance and i don't blame them. On top of that excessive patient demand, i see so many worried well, I totally understand them as they want to remain healthy so that they can continue to work and pay for the mistakes of bankers. To completely floor us, is the ever growing litigation culture.
Why would a new doctor choose to become a GP?
I am concerned about rates of Burnout in existing GP's, What does GPC propose we should do?
That's an ineleligtnt answer to a difficult question xxx
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