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The waiting game

Government reveals £50m new clinical areas

By Gareth Iacobucci

Ministers have released plans for a range of enhanced services for conditions ranging from osteoporosis to alcohol misuse, to take the £50million of new clinical funding agreed under the revised GP contract.

GPs will be paid for implementing NICE guidance on osteoporosis and heart failure under the proposals, in measures originally recommended for a revised QOF.

But there are also a number of less-expected measures, with new enhanced services for annual health checks in patients with learning difficulties, improved collection of ethnicity data and increased support for harmful drinkers.

But GP clinical experts criticised the plans as vague and questioned whether they would work as well as a simple expansion of the QOF.

It also emerged that the money will remain frozen as the dispute drags on with the BMA over the legality of the freeze to the MPIG as part of the GP pay deal.

Health secretary Alan Johnson claimed the Government would soon begin negotiations with the BMA over the stalemate, which has seen the investment put on hold while GP leaders dispute the legality of the income freeze.

Mr Johnson said the plans would allow investment in ‘best practice' for osteoporosis treatment and increased support to overcome harmful drinking.

‘This is about developing high-quality services with a strong focus on prevention. It's a great opportunity for entrepreneurial GPs as well as social enterprises, voluntary organisations and the independent sector to develop innovative services.'

The Department of Health said it would be consulting on the new measures, but that the heart failure DES would focus on implementing NICE guidance for prescribing – expected to focus on use of [beta]-blockers – and the osteoporosis DES would focus on diagnosis and treatment, again according to NICE.

On top of the clinical money, a further £50 million would be invested locally by PCTs to improve access and responsiveness of GP services.

GPC chair Dr Laurence Buckman welcomed the announcement of some detail on the new clinical funding, but added: ‘Paying doctors fairly is a completely separate matter and we look forward to hearing what the Department of Health has to say.'

But experts said major question marks remained over exactly how the money would be spent.

Dr Jonathan Bayly, a former GP and scientific adviser to the Osteoporosis Society, also welcomed the plans, but said he was concerned about their lack of detail.

He added: ‘A DES doesn't have the weight of QOF points, so we need to see this robustly measured.'

Dr Ahmat Fuat, a GP in Darlington and deputy chairman of Primary Care cardio-vascular society, doubted whether the money would be sufficient: ‘You'd probably need £50m to tackle alcohol alone.'

Alan Johnson: details of new £50m clinical areas Alan Johnson: details of new £50m clinical areas Where the £50m will go:

• new measures to improve prescribing in heart failure
• investment in best practice on osteoporosis treatment
• annual health checks for people with severe learning disabilities
• better data to improve patient care for people from black and minority ethnic groups
• increased support to overcome harmful drinking

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