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At the heart of general practice since 1960

Income guarantee protects low-quality GP practices

One of the negotiators of the GMS contract has attacked the minimum practice income guarantee, claiming it 'heavily diminishes' the original intention to shift resources to

poorer practices.

Dr Tony Snell, a member of the NHS Confederation negotiating team, said better-off practices with big lists that offer poor quality care would be protected by MPIG. 'The original concept we had was to try to do something about high list-size practices and poor quality, and the original version of the contract before the changes did that,' he said.

'The changes being made I think mitigate against that and I'm not sure the new version will engage with it.'

Speaking at a recent NHS Alliance and National Primary Care Development Team conference, he said the 25 per cent minimum performance level at which GPs begin scoring points against clinical markers on the quality and outcomes framework was 'far too low'.

Dr Snell added: 'From a patient's perspective, that minimum standard of acceptable care across the board sends an incredibly negative message.'

Dr Mary Church, co-chair of GPC Scotland, said she 'fundamentally disagreed' with Dr Snell's view. 'I have much more faith in GPs,' she argued.

'Once you achieve something [the quality framework] will encourage you to achieve more. We're trying to enable and encourage GPs, not threaten them. If the hurdles were too high, the ones that are struggling will not do it,' she added.

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