This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

Gold, incentives and meh

GPs to vote on introducing a 'fully salaried service'

GP leaders are set to vote on whether general practice should become a fully salaried service at the LMCs Conference later this month.

It is one of a number of potentially controversial motions to be debated at the conference on 21-22 May in London, including suggestions get rid of the QOF in its entirety, abolish the CQC and bring in a new ‘staff grade’ GP.

However, the salaried model motion from the Liverpool conference region is likely to be the most controversial.

It proposes that ‘conference believes that the model of the self-employed independent practitioner has been so eroded by the current contract and regulatory regime, that the GPC should be exploring the establishment of a fully costed and salaried GP service’.

The motion follows similar calls by former RCGP chair Professor Clare Gerada and NHS England (London), while NHS Hull CCG has also looked into developing a fully salaried model.

Other motions call on the GPC to include in the GP contract the potential of practices offering ‘top up’ private services to their NHS patients, with the motion from Gloucestershire stating that this would improve patient care.

Elsewhere, one motion calls for practices to be allowed to ‘declare major incidents and capacity shutdowns in a similar manner to A&E’, at the same time as calling for enough resources to ensure they can offer standard appointment lengths of 15 minutes.

The agenda is dominated by issues relating to workload and recruitment. One of the suggestions to improve GP recruitment is to introduce a ‘staff grade’ of GP, who are able to practise safely independently, but who have not reached the standard of the MRCGP exam.

It follows a row over the MRCGP exam, which international doctors’ groups said were discriminating against international medical graduates, leaving many GPs unable to continue practising.

The CQC - which has recently apologised for rolling out its ‘intelligent monitoring’ risk ratings, which unfairly branded practices as a risk to patients - is the subject of a number of motions, with the main motion to be debated demanding for it to be decommissioned.

GPs will also debate the abolition of a number of other bodies and services, including NHS 111, the unplanned admissions DES, QOF and co-commissioning.

Read the agenda in full here

Highlight motions in brief:

LIVERPOOL That conference believes that the model of the self-employed independent practitioner has been so eroded by the current contract and regulatory regime, that the GPC should be exploring the establishment of a fully costed and salaried GP service.

 

GLOUCESTERSHIRE That conference believes patient care would be improved were practices to be allowed to offer ‘top up’ private services to their NHS patients and requests that the GPC include this in their contract negotiations.

 

HAMPSHIRE AND ISLE OF WIGHT: That conference supports the creation of an intermediate grade qualification for GPs, similar to staff grade in hospitals, to allow a career path for GP registrars whose practice is safe but does not reach the standard required for the MRCGP qualification, to avoid the loss of this potentially useful workforce to the profession.

 

AGENDA COMMITTEE to be proposed by DEVON: That, in the interests of the safety of patients and the health of GPs, conference demands that practices should:

(i) be resourced to limit the maximum list size to no more than 1500 patients per whole time equivalent GP

(ii) receive increased funding to be able to offer standard consultation times of 15 minutes

(iii) be able to declare major incidents and capacity shutdowns in a similar manner to A&E, supported by equal access to emergency resources at times of system stress

(iv) have the right to close their list when they alone decide it is unsafe to take on more patients

(v) be enabled to ensure GPs do not work beyond the legislated hours of the European Working Time Directive.

 

AGENDA COMMITTEE to be proposed by the GP Trainees Subcommittee: That conference calls on GPC to work with the RCGP to ensure the GP training curriculum encompasses:

(i) commissioning, management and clinical leadership skills

(ii) finance, business management and business skills

(iii) IT

(iv) health and justice

(v) resilience.

 

COVENTRY: That conference deplores the bureaucratic and incompetent nightmare of the CQC, and demands that it is

decommissioned forthwith and that the funding is reinvested in frontline services.

 

AVON: That conference calls on the government to abolish the unplanned admissions enhanced service for 2016/17 as it:

(i) lacks evidence as a policy

(ii) has not achieved its intended aims, as A&Es are inundated with patients and hospitals struggle to cope with demand

(iii) has meant clinicians have had to focus on processes and paperwork rather than on patients

(iv) puts GPs in medico legal danger

(v) was always destined to fail.

 

 

Source: LMCs Conference agenda

Readers' comments (77)

  • The less the GP Partners talk about the future of General Practice - the better. GP Partners do not even make up 20% of GP workforce. The voice of Salaried and Locum GPs should be heard more when deciding on the future of General Practice.

    The GP partners should introspect as to why GPs are not willing to join their surgeries. There is no point in GP Partners trying to simply the situation by saying - if there is more funding there will be more recruitment.

    The best way forward for the General Practice in the UK is to make every GP Salaried. In an all-salaried GP model there will not be any more recruitment crisis, there will not be any disillusionment, there will not be any disparity and there above all there will be fairness to all.

    Unsuitable or offensive? Report this comment

  • " In an all-salaried GP model there will not be any more recruitment crisis, "

    Why on earth do you think that?

    Do you think things will be better when everyone get's paid less?

    Unsuitable or offensive? Report this comment

  • Bob Hodges

    " In an all-salaried GP model there will not be any more recruitment crisis, "

    What a bizarre statement.

    How will that increase the number of GPs available/willing to work?

    Unsuitable or offensive? Report this comment

  • I see many bitter salaried colleagues who will jump at this idea without realizing what this means.

    Have a go at working for any private firms with turn over of >£1m. You will soon realize how cozy BMA contact is and the 'contact' will do very little to protect you. In fact it will be used against you. Just remember who has more time, experience and money to scrutinize a legal document.

    And lack of gps will be compensated by these firms with physicians assistant. Why do you think government and gp leaders are pushing this? Just look at the nursing homes, most will use low paid low quality stuff to maximize the profit and use NHS resources (I.e. GPS) to supplement their lack of provision. Exactly same will happen with private salaried primary care model and secondary care costs will sky rocket.

    Unsuitable or offensive? Report this comment

  • The most successful part of the NHS has been general practice. Since NHS inception it was privatised or rather never nationalised. Hopefully any government would refuse to do such a thing and directly employ more doctors.

    Unsuitable or offensive? Report this comment

  • Labour promised to increase GP numbers by 8000 during the tenure of their Government. This will obviously benefit the patients by them getting timely appointments.

    There is no way that such large numbers of GPs would join the existing surgeries that are badly managed by the current partners.

    The only way to ensure that more GPs are employed and provide service to the patients is by making all GPs salaried. This will not only relieve the existing partners of the huge administrative responsibilities that they currently shoulder, but also allow them to increase their clinical sessions if they still wish to earn a decent income

    Unsuitable or offensive? Report this comment

  • Sad that once again the GPC in the guise of the LMC conference shuts out debate about GPs resigning from the NHS contract and going private. Why isn't that option up for debate alongside wanting a vote on becoming salaried?

    Unsuitable or offensive? Report this comment

  • Anonymous | Salaried GP | 05 May 2015 11:39am
    'The only way to ensure that more GPs are employed and provide service to the patients is by making all GPs salaried.'

    How is anyone so blinkered that they think more trainees will want to be GPs to become salaried and paid less than currently?

    Unsuitable or offensive? Report this comment

  • 'In an all-salaried GP model there will not be any more recruitment crisis, there will not be any disillusionment, there will not be any disparity and there above all there will be fairness to all.'
    .....urrrr why???
    What an empty clueless statement of nothingness this is.

    Unsuitable or offensive? Report this comment

  • if we all worked together the NHS could be saved.

    if we all became salaried we could work in a rota and provide access 24 hrs a day 7 days a week. continuity could be provided by having patient lists and use of technology. if we all reduced our pay to say 54k a year think of all the money that could be saved and put back in the nhs pot? we will also have PAs and ANPs to help us so we will be left with the most interesting and exciting cases to deal with. Our employers such as Hurley group will take care of all the stressful admin and financial work and we can concentrate on patient care.

    come on - vote salaried and save the nhs.

    Unsuitable or offensive? Report this comment

View results 10 results per page20 results per page50 results per page

Have your say