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A faulty production line

GPC defends 2014/15 contract negotiation following GP critique

The GPC has defended its negotiation of the 2014/15 GP contract, following criticisms from GPs who felt the contract had failed to reduce bureaucracy.

Speaking at the Pulse Live conference in London today, GPC deputy chair Dr Richard Vautrey said the GPC was focused on ensuring GPs’ ‘core’ work is being funded and allowing GPs to use their clinical judgement to a greater extent by achieving QOF concessions.

He also said the work involved with the unplanned admissions DES was mainly ‘in line with good medical practice’.

Last week, a Pulse survey revealed that 69% of GPs did not think that the deal negotiated between the GPC and NHS England had reduced bureaucracy, while one in seven was planning to refuse the new unplanned admissons DES, due to bureaucracy concerns, despite it being worth £20,000 for the average practice.

But Dr Vautrey said the main aim was to remove box ticking.

He said: ‘We wanted to try and address, rationalise, make sense of and actually get rid of some of the inappropriate stuff that you really didn’t need to micromanage in that particular way. You may well want to do surveys for exercise and whatever but you shouldn’t be forced to do it just because a patient has hypertension, and so we have removed some of those inappropriate indicators.’

‘We also wanted to reduce the workload of box ticking that not only you were doing, but the practice nurses, which was pointless if you were only doing it because QOF tells you to do it.’

‘We really wanted to reduce the workload of QOF but also reintroduce professionalism again, [and] we also wanted to start to try and transfer some of the resource from QOF and into the core contract, which is where it belongs.’

In defence of the DES, Dr Vautrey said that while the workload should not be underestimated the work involved should be ‘in line with good medical practice’, adding that the GPC had won concessions against the Government which wanted targets for reducing A&E admissions to form part of the specification.

He said: ‘We shouldn’t underestimate that this is a big piece of work which will cause a lot of challenges for many practices but should be in line with good medical practice.’

‘And importantly, while this is an enhanced service to try to reduce emergency admissions, there is no target to reduce admissions to hospital. We fought against that because we thought that it was clinically dangerous and inappropriate, and fortunately we were listened to.’

Further making his point, Dr Vautrey said: ‘The contract does not mention longer opening hours, which many GPs thought they would be compelled to do. Equally, patients having access to GP records, which is something that was threatened, does not form part of the contract deal.’

But he added: ‘Sadly, there’s no new money as part of this year’s deal either. It was very clear in the contract negotiations that it was up to the DDRB to make an award. Sadly they came up with the “massive” 0.28%… which in reality is a pay cut. But the contract negotiation was not about additional money, it was about utilising the resources that we have already got.’

Readers' comments (7)

  • I sympathise with Dr Vautrey, the GPC clearly get no credit for the " might have been much worse" that they averted in the in camera negotiations.
    However to the " street GP" an unsustainable workload, a continuing micromanagement by NHS England, falling residual income, rising expenses and the general perception the state is wiflully bankrupting small independant providors to permit a " privatisation of the NHS" -( effectively evicting the "sitting tennants" in a very profitable bit of real estate it owns for sale)- does not make for much joy.
    May we please be pleasanter with our colleagues of all persuasions GPC/ NHS Management Physicians unless we have definitive evidence they are wilfully selling the profession down the road?
    My own opinion of Dr Vautrey is he is a no nonsense yorkshire man with integrity and bloody mindedness in eaqul measure and I don't doubt it would have been very much worse without the GPC efforts.
    You cannot move a democratic government with fixed ideas short of civil war and revolution, and I don't have the time to do the CPD on battlefield injuries currently.

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  • Took Early Retirement

    Sadly, I do not sympathise with any of them. (Threads passim ad nauseam.) We can always, say, "Without the GPC it would have been much worse", but not long ago we had a contract imposition, so the GPC did nothing then, did they?

    Peter Holden says elsewhere on this website that they can't do anything. So- why worry?

    As to it being "good medial practice", well this is true of much of what we do, and hopefully all of it, if you think about it.

    We are clearly back , then, to the "John Wayne" contract of 10 years + ago, and no further on except years of pay cuts.

    I'm glad I'm off: 29 days and counting. With a bunch of wallies like this negotiating on our behalf, we'd be better off in Unison or the RMT.

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  • Vinci Ho

    I can see the arguments from both sides. No matter what , we are living in a country where the government is elected through a democratic exercise . The argument could have been democracy only occurred at the time of election and immediately evaporated after it finished.
    Nobody should deny this is desperate and critical time in history for general practice in the country . If the representative politics displayed by the current elected government betray certain fundamental principles, the democracy will easily go back to people on the street.
    While I support protesting , I certainly hate to see us fighting against each other . As I said this morning , politicians are exploiting our desperation , exhaustion and grief and turn us all into 'demons'......
    'There will always be those
    who mean to do us harm
    To stop them , we risk awakening the same evil within ourselves '
    Kirk Star Trek into Darkness 2013

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  • Unfortunately good medical practice to those that spent the least of their working time on the front line usually implies they believe we should be performing the work with no additional resources.
    This time next year we will be debating the contractual imposition of the ES as past of our core work with the GPC agreeing to another significant workload increase to maintain the (gross) financial status quo. It is about time they turn around and say this is the best deal we can get, we recommend as a profession that it is unanimously rejected. Why keep denying us a vote?

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  • There are negotiations that can be won our lost and they're ate negotiations that didn't even happen because the negotiators are simply out maneuvered.

    I seem to recall a recent article on QoF payment where GPC failed to even consider negotiating this.

    The only successful negotiation they seem to be doing is telling us their job is to difficult and cannot be done to our satisfaction so we should be happy with what we've got. Which side are these people on again?

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  • Listening to Richard Vautrey yesterday I thought primary care is in real trouble. There is no real strategic leadership and just asking for more money has not worked. it needs a fresh approach

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  • I think it is time for the GPC to link payments per 1000 patients to appointments per 1000 patients and stick to it. Payments go up, appointments go up, payments go down and.....

    It will shift the focus of managing demand away from GPs and back to the department of health.

    It will mean that work moved out of hospital either has to be funded or there has to be an understanding that it will reduce access to primary care.

    It can be done unilaterally without negotiation (as a guideline) and those falling outside the appointments will need to seek healthcare from the A+E department. If it overwhelms the A+E department, then they will need to invest in primary care.

    Problem solved.

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