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CAMHS won't see you now

GPs get power to hold PCTs to ransom over NSF targets

GPs will gain new bargaining power to demand cash for meeting national service framework deadlines as primary care trusts come under pressure from Government watchdogs not to neglect the high- profile targets.

NSFs do not feature in the new contract ­ because most apply only to England. But PCTs will still be monitored by the Commission for Healthcare, Audit and Inspection to ensure they meet targets.

GP leaders are predicting that NSF targets could be shunted into the local enhanced services section of the contract, leaving GPs able to hold PCTs to ransom with an ultimatum to pay them the going rate or see the work neglected.

New targets on heart failure and cholesterol levels are expected this year and new frameworks for children's services, long-term conditions and renal failure are due within the next two years.

Dr Simon Fradd, GPC joint-deputy chair, said PCTs would face the choice of paying GPs the market rate for the work or commissioning other service providers to do it instead. He said: 'PCTs will just have to get on with it. Payment will be on a supply-and-demand situation. It will be the market price and not the cut-down rate we've been used to.' He added: 'Some pieces of work might be possible to deliver through other providers, which will control the price a bit.'

Under the new contract, fees for locally enhanced services are agreed between practices and their PCT. Either party can ask the LMC to help smooth negotiations.

Dr Ian Dumbelton, chair of Cambridgeshire LMC and a GP in St Neots, Cambridge-shire, said market forces would play a significant role in GPs' decision whether or not to opt into local enhanced schemes aimed at meeting NSF targets.

He said: 'It is inappropriate to do the work if you are not paid and it is only appropriate if we get the resources in addition to the money.

'The biggest difficulty is finding the manpower to do the work.'

Do you think your practice will neglect NSFs in favour of chasing quality points?

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