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GPs still face having to take forced allocations

GPs may still have to take on forced patient allocations under the contract.

Changes to the system for allocations will give trusts the right to refuse GPs' application to close their list. GPs will also have a new obligation when they remove a patient to give a reason to their primary care organisation and the patient.

GPC negotiators had pro-mised the contract would bring an end to forced allocation, but argued the new system meant the issue would no longer be a mere 'administrative exercise' for a primary care organisation.

'Instead of being a junior member of a primary care organisation being able to say ''this patient needs allocating'', there will be a three-stage process,' said GPC joint-deputy chair Dr Simon Fradd.

'But the bureaucracy all falls on the PCO to show there is no other way they could care for these patients.'

The deal will bring a 'net effect' of reduced allocations, he added.

The three-stage process will treat allocations as a last resort, involve senior trust managers and give GPs an appeal mechanism at every stage, according to the GPC's outline for the contract.

If GPs want to close their list, the practice will have to give a primary care organisation notice it wants to refuse allocations.

A review and discussion process with the trust lasting a maximum of 28 days will then be held to try to keep the practice list open. If no agreement is reached, the practice has to issue notice to the trust that it is closing its list.

It can then either approve a 12-month list closure or consent to drop the list to an agreed number of patients.

If the trust rejects the list closure, an assessment panel of LMC representatives, a health authority director, the chief executive of the trust and a patient has to review the case.

If they agree that a list must stay open, it must do so for six months. GPs will then have to appeal to the strategic health authority.

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