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Contract delay putting extra stress on GPs

I am writing regarding the question of additional stress due to the new contract.

I work in a seven-partner, 11,200-patient practice and we are paper free, with a document management system, scanning and shredding our incoming mail, with a data entry clerk to input clinical data from hospital letters into the clinical system.

You would therefore assume correctly that we would be well-placed to fulfil the needs of the quality and outcomes framework. I have been delegated the responsibility for IT and for the needs of the new contract, and given a session a week to spend on this work.

My partners have also shared out the responsibilities for the assessment of provision on enhanced services. We have a management team and are working together towards all aspects of the new contract.

I thought the contract was to bring benefits of a high-trust culture and reduced bureaucracy but I don't see any evidence so far. I appreciate, having been through the 1990 contract, that there is initial work involved.

Despite this, I am working longer hours than ever, trying to keep up with the paperwork involved, and all the implementation documentation, and the implications. I am working regularly 10 hours per day, getting home later and later. For what?

If things don't settle down soon I know I will not be able to keep up with the pace of work. I do wonder how practices that are not as IT literate, without the management capacity that we have, can possibly be coping, if they hope to succeed, especially with the Q&O framework.

I feel as though I am just about keeping my head above water trying to keep up with my clinical work, as well as the administrative side of day-to-day practice, let alone the contract.

I am working hard to keep my motivation and enthusiasm high, which they are at the moment.

I hope the benefits of the contract will soon start to come through – we haven't even received our global sum/MPIG yet.

It is the delays in the implementation of the contract that are partially to blame for the extra stresses at the moment and for that I do think the negotiators and the Department of Health must accept the responsibility. We are running on the treadmill to get everything done for April 1.

I doubt we will all succeed.

Dr Anthony Kaye

Davyhulme, Manchester

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