General practitioner England

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DH threatens to impose GP contract changes

GP leaders have reacted furiously to government threats to impose contract changes after five months of talks.

BMA GPs committee chair Laurence Buckman said the implications for GPs were huge.

He spoke out after health secretary Jeremy Hunt issued a statement saying the GP contract needed to change to ‘further improve care for patients'.

Dr Buckman said: ‘The government is being disingenuous in its presentation of how we have arrived at this point. GPs will be stunned and angered that it is disregarding five months of detailed negotiations between the BMA and NHS Employers.

'The government must rethink its approach and return to our negotiated settlement that was so close to being concluded.’

Patient satisfaction

He added: ‘The government’s surveys show patients consistently recognise GPs’ commitment to [them]. Doctors have always been at the forefront of driving up standards, and we do that by responding to sound evidence, not ill-considered quick fixes.'

Dr Buckman said there were ‘serious questions’ as to whether the proposed changes were evidence-based, practical or feasible.

He added: ‘Many practices are already stretched to breaking point, which the government appears to be ignoring. The changes will place an enormous strain on GPs at a time when they are struggling under the weight of a wholesale NHS reorganisation.’

Mr Hunt said he made no apology for ‘putting patients first’. His proposals include changes to the QOF (quality and outcomes framework), to end points for organisational tasks such as good record keeping and staff training.

Instead, GPs would earn points for meeting a number of new targets based on NICE (National Institute for Health and Clinical Excellence) advice. There would also be higher thresholds for achieving QOF points and funds. The government wants new measures to help patients with long-term conditions and to cut down on unnecessary emergency admissions.

New quality improvement schemes

Mr Hunt said: ‘Our proposals will help ensure that we provide the very best care and support possible for those at most risk of life-threatening conditions.’

The government wants to see new quality improvement schemes for the diagnosis and care of people with dementia, care for the most frail or seriously ill patients, patient access to online services, and support to help people with long-term conditions better monitor their health.

Dr Buckman added: ‘Doctors recognise that we are in tough economic times, and the BMA has been committed to achieving a negotiated settlement that delivers genuine improvements for patients while being realistic about what practices can deliver.’

The changes relate to England. It is not yet clear what will happen in the devolved nations.

An NHS Employers spokesperson said: ‘It is disappointing to report that we have been unable to reach an agreement on a negotiated settlement…

‘Our discussions on contract changes with the GPC have focused on improvements to patient care delivered through implementing the NICE recommendations to the QOF, as well as reducing the variability in funding between practices.’

Formal consultation process

If the GPC does not agree changes to the GP contract, the government will begin a formal consultation process next month, seeking to impose the changes. The government is offering a 1.5 per cent uplift — but only if a negotiated settlement is reached.

Other changes include a gradual move to reduce variability in practice funding over seven years.

Dr Buckman will email all BMA GP members about the imposition. A further, detailed analysis of what the proposals mean is already under way, and will be sent to GPs when it is finalised.

The BMA has already warned the government that GP workloads are reaching saturation point. Doctors leaders will be making the strongest possible case about the damaging impact of the imposition to ministers.