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Compromise on enhanced services pay

By Joe Lepper

GPs are moving to strike compromise deals with cash-strapped pri- mary care organisations to set up lower-paid, lower-specification versions of national enhanced services.

The move marks the first signs of a break in the impasse between LMCs and PCOs after GPs in many areas threatened to stop doing any services they were not paid for.

LMCs have proposed setting up local enhanced services that involve less work for GPs but also pay less money as an interim deal until the PCO can afford to commission the full national version.

Avon LMC said it was close to agreeing deals on services including drug misuse, sexual health and depression.

PCOs in the region had said they could not afford to commission any national enhanced services as they are having to cover a £44 million debt racked up by North Bristol NHS Trust.

LMC director Dr Simon Bradley said GPs would still only be doing work they were paid for. He added: 'If we can come up with a compromise then that's better than not offering the services at all.'

The deal would be an interim measure lasting a year at most, he said.

Surrey LMCs chief executive Dr Tony Welch said talks between GPs and PCOs in west Surrey were due this week over introducing a downgraded drug misuse service. He added: 'The view here is we shouldn't be making major changes overall.'

Norfolk LMC, one of a number of areas in dispute with PCOs, said it would consider a local deal. LMC secretary Dr Peter Harvey said: 'If it's something the PCT wants to commission and GPs want to do it then it's a good idea.'

Liverpool and Leeds said they were also considering compromise agreements.

But East Yorkshire LMC secretary Dr Russell Walshaw said he did not think the plans would work. 'I don't believe in just paying for some parts of the service. Why should we settle for less?'

GPC negotiator Dr Ham-ish Meldrum urged GPs involved in negotiations over national enhanced services to use the benchmark specifications as guidelines.

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