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At the heart of general practice since 1960

Extra 33 per cent for practices ­ but there will be losers too

GPs have been promised a 33 per cent average increase in resources for their practice under the contract. But negotiators have refused to say how much GPs' pay will rise and have admitted some GPs will lose money.

GPC negotiator Dr Peter Holden said the increase in resources would range from 10 to 50 per cent depending on where the practice was based. 'If you are well staffed in a poor area you are going to get the most money. If you are highly staffed in a well-off area, you are going to make less,' he added.

GPC chair Dr John Chisholm said GPs struggling to achieve the most basic quality markers were likely to see a drop in pay and would need to focus more on quality.

The Government has committed £1.9 billion to the contract, £1.3 billion of which is tied to the quality and outcomes framework. The remaining £600 million will be paid via the global sum.

Dr Chris Town, NHS Confederation negotiator, said GPs would be paid a third of their income through essential services, a third through additional and enhanced services and a third through the quality framework.

The global sum payment to each practice will be based on a notional patient list size based on the age and gender of the list; list turnover, morbidity, the number of nursing home patients, the rurality of the practice and staff costs.

Global sum replaces:

 · Basic practice allowance

 · Assistants

 · Deprivation

 · Capitation

 · Out-of-hours

 · PGEA

 · Staff costs

 · Appraisal

 · Unregistered patients (temporary residents)

 · Cytology (partly)

 · Vacs & lmms

 · Contraceptive ­

non-IUD

 · Rural practice payments

 · Some minor ops

 · Maternity except intrapartum

 · Arrest of dental haemorrhage

 · Employers' contribution to superannuation

Global sum does not include:

 · Structured health promotion

 · Chronic disease management (diabetes and asthma)

 · Dispensing

 · Premises

 · Computers

 · Maternity (intrapartum)

 · Geographical payments

- Inducement

- Rural locum

- Associate

- Initial practice

- Designated area

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