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BMA GP Contract Imposition Survey

The BMA has asked all GPs in England to answer the following survey on the impact they expect from the Government’s contract imposition. It will use the data to inform its response to the consultation which closes next month.

GP Contract Imposition Survey

The Government’s Proposed Contract Imposition

On 7 December 2012, the Government published proposals for changes to GP contracts, which we anticipate will be imposed from April 2013 following a consultation with the BMA’s General Practitioners Committee (GPC).  The BMA and other interested parties now have until 26 February to respond to the detailed proposals.  The GPC represents all GPs and we want to ensure that the Government hears from as many GPs as possible through our response.  The results of this survey will help us to clearly convey GPs’ thoughts on the changes.  Details of the proposals can be seen at [[http://bma.org.uk/working-for-change/negotiating-for-the-profession/gp-contract]].

The GPC will continue to talk to the Government in an attempt to ameliorate the most unacceptable elements of the proposals. If the Government does still impose the proposals in their entirety with no changes, do you expect your practice to do anything differently?

  • Yes
  • No
  • We don’t know enough about the proposals at the moment to know what actions we might take

 

How will you manage if the Government does still impose the proposals in their entirety with no changes?

  • We shall try to preserve existing resources within current services and staffing by working longer
  • We shall try to preserve existing resources within current services and staffing by working harder

 

What actions would you expect your practice to take?

  • We shall have to make changes to clinical and/or administrative staff working hours or employment
  • We shall have to reduce access to patients
  • We shall have to reduce involvement with our local CCG
  • We shall have to reduce our use of locums

 

Please select any of the following options you may consider to make changes to staff working hours or employment:

For clinical staff / For administrative staff

  • Take on more staff to meet the extra workload
  • Increase the working hours of staff members
  • Reduce the working hours of staff members
  • Make staff redundant
  • Not replace staff who leave
  • Not recruit any new staff

 

Please select any of the following options you may consider if you have to reduce access to patients:

  • Reduce the range of services we offer to patients
  • Reduce the number of consultations to free up time for the new workload
  • Not be able to see patients for routine appointments as quickly as we currently do

 

Do you think a reduction in the use of locums will result in any of the following:

  • Reduced patient access
  • Increased workload of permanent practice GPs
  • Increased workload of other practice staff
  • Reduced involvement with our CCG

 

For you as an individual GP, do you expect to do anything differently?

  • Yes
  • No
  • I don’t know enough about the proposals at the moment to know what actions I might take

 

What actions do you expect to take?

  • I shall make changes to the amount of work I undertake
  • I shall seek a post as a sessional GP (locum or salaried) if currently a contractor
  • I shall leave the NHS

 

Please select any of the following options you may consider if you have to make changes to the amount of work you do:

  • Reduce the amount of out of hours work I do outside my practice
  • Reduce my personal contact with our local CCG
  • Increase the amount of work I do outside my practice to maintain my income
  • Reduce the amount of administrative work I do inside my practice
  • Reduce the amount of training I currently provide
  • Reduce my hours of work overall
  • Increase my hours of work overall

 

If you leave the NHS will you:

  • Seek work as a doctor in another country
  • Seek work in a different career
  • Take retirement earlier than planned

 

How has this proposed imposition affected your personal view of general practice?

Slider selection of the following answers to the statements given below:

Disagree/Slightly disagree/No change/no opinion/Slightly agree/Agree

  • I am less enthusiastic about general practice as a career
  • I am less likely to recommend general practice as a career for new doctors
  • I feel less able to achieve a satisfactory work-life balance
  • I feel less able to manage my own workload
  • I believe general practice will become more stressful for me
  • I believe I shall be less able to offer good quality care to my patients
  • I believe I may be forced into alternative career paths

Now looking at the different elements of the imposition, for each change below please indicate on a scale of 0-3 what the impact on staffing, services and income will be for your practice (where 0=Major negative impact, 1=Minor negative impact, 2=No impact, 3=Positive impact, 4=Don’t know or have no opinion) (impact)

  • Phasing out of Correction Factor payments over a seven year period from 2014/15 and moving towards a standard weighted per capita payment for all practices
  • Reducing PMS funding over a seven year period from 2014/15 and moving towards a standard weighted per capita payment for all practices
  • Implementing all the changes to the Quality and Outcomes Framework (QOF) recommended by NICE irrespective of the ability of primary care to deliver them
  • Increasing upper thresholds for 20 QOF indicators in 2013/14 and for remaining indicators from 2014/15 to match upper quartile achievement
  • Ending most of the QOF organisational indicators and requiring GPs to take on new additional work to retain this funding
  • Reducing the time period for most QOF Indicators from 15 to 12 months
  • Introducing significant new work through four new DESs (dementia testing, risk profiling, online access, long-term condition remote monitoring)
  • Changing the contract to introduce a £7.63 fee for a completed course of rotavirus for infants, and for shingles immunisation for patients aged 70

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