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At the heart of general practice since 1960

2008 - the year through the pages of Pulse

Our look at the highs and lows and the big stories we've covered this year, from contract collapse to the rise of the GP-led health centre.

Our look at the highs and lows and the big stories we've covered this year, from contract collapse to the rise of the GP-led health centre.

January

The year began with the BMA and ministers deadlocked plans for extended hours. GPC leaders, outraged at the Government's ‘gun-barrel' negotiation tactics, polled the profession on option A versus even lass palatable option B. They considered going further – outlining an ‘end of the world' scenario for all GPs to quit the NHS.

February

What a difference a month makes. After a crunch meeting the GPC abruptly backed down, claiming the extended hours battle was



‘unwinnable'. Meanwhile, a Pulse investigation revealed hospitals across the country were abusing Choose and Book by restricting appointments in a desperate bid to hit the 18-week target.

March

A future of ‘blood, sweat and tears' – the most Churchillian GPC negotiator, Dr Peter Holden, captured the mood after GPs reluctantly voted to accept the Government's contract offer. Pulse launched the Save Our Surgeries campaign as private companies queued up to run polyclinics. But there was some good news, with the BMA winning its High Court battle against the GP pensions cap.

April

GPs got a ‘further slap in the face', as BMA chair Dr Hamish Meldrum put it, with news 90% of practices would receive a third successive pay freeze. Pulse revealed out-of-hours providers were ‘performance managing' GPs to control costs, while internal memos from care record pilots gave a chaotic picture of delays, confidentiality concerns and pull-outs.

May

The internal memos were right: an evaluation found confusion over care record implied consent and urged a fundamental rethink. NICE



was set for a rethink too, after Pulse revealed it had reversed a decision to ditch the Framingham charts. And support grew for the SOS campaign, as PCTs in London prepared to axe more than 100 GP surgeries to make way for polyclinics.

June

Ministers were finally ready scrap the MPIG, with sources predicting it would go ‘within weeks'. GPs faced funding cuts of a different kind with plans to shift up to £300 million from GP drug budgets to pharmacists. A stormy LMCs conference saw the GPC instructed to consider GP commissioning of out-of-hours, while the BMA's strangely familiar Support Your Surgeries campaign collected 1.2 million patient signatures.

July

July was Darzi month, with the health minister's NHS Next Stage Review heralding the end of MPIG as part of a drive to force practices to compete for patients. Pulse revealed practice-based commissioning was still stuck on the starting grid, with just 5% of PCTs reporting successful schemes. And Londonwide LMCs chief executive Dr Michelle Drage received widespread support after becoming a woman.

August



The drug regulator was poised to approve plans for a mainstream antibiotic to be available over the counter – despite warnings the move would be ‘disastrous'. GPC leaders claimed they had been left out of the loop over plans for a national MMR catch-up campaign. Connecting for Health, meanwhile, confirmed it would switch to a ‘consent to view' model for the care record.

September

GP commissioning of out-of-hours returned to the top of the agenda as ministers entered talks with the NHS Alliance over the proposals. Virgin Healthcare dramatically shelved its GP plans as the credit crunch bit. And an investigation overseen by guest editor Dr Fay Wilson found female GPs were still underrepresented in leadership roles.

October

After a year of sniping, peace appeared to have broken out between the Government and the GPC, with an agreement to reshape the contract. But as GP referrals spiralled, there was controversy over PCT schemes to pay GPs not to send patients to hospital. Practices were also split over a law firm's advice on how to sidestep the BMA's ‘dreaded' model contract for salaried GPs.

November



Further seismic shifts in GP funding, with news NICE was to reshape the QOF by cost-effectiveness – and could scrap almost half clinical indicators. GPs were told they would be screening for pre-diabetes. And in a month full off bright ideas, Connecting for Health came up with a novel way of improving access – consultations by email.

December

Pulse's revelation of pilots offering the contraceptive pill without prescription made headlines. The announcement from Baroness Young, chair of the Care Quality Commission, that GPs could face prosecution if they failed to follow NICE guidance won her few friends. The end of the year also brought procurement for GP-led health centres to a close, with 15 private companies chasing every one.

November: We reveal plan for email consultations, a Connecting for Health bright idea November: We reveal plan for email consultations, a Connecting for Health bright idea September: The first signs of the credit crunch hitting general practice September: The first signs of the credit crunch hitting general practice June: Pulse reveals the plans to abolish the MPIG June: Pulse reveals the plans to abolish the MPIG March: We launch our Save our Surgeries campaign March: We launch our Save our Surgeries campaign January: The year starts as it means to go on, with the BMA and DH at loggerheads January: The year starts as it means to go on, with the BMA and DH at loggerheads

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