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GPs can expect only minor changes to the quality framework and the Carr-Hill formula for next year, the GPC and NHS Employers have revealed.

Negotiators for the two sides said lack of time to

consider evidence and the need to give GPs space to take on practice-based commissioning meant major changes would be delayed until at least 2007/8.

But the GPC also admitted the move will mean a comparatively small pay rise for GPs for 2006/7 as the recent flood of Government investment in the NHS slowed to a trickle.

Dr Hamish Meldrum, GPC chair, said ministers were nervous about committing money to fund major changes to the QOF because of GPs' 'over-delivery' last year.

'We have been considering not making major changes this April,' he said. 'We may get a better deal for general practice if we don't try to get too much too quickly.'

He added: 'We are one of many Oliver Twists holding out our bowl asking for more.'

Dr Barbara Hakin, chair of the negotiating team for NHS Employers, said a 'two-stage' approach would allow the implications of the 'Health care outside hospitals' White Paper, due in the new year, to sink in.

The White Paper is expected to open up primary care to more competition and could affect the principle of registered lists. All practices are also expected to take on practice-based commissioning by the end of 2006.

'This is not a definite solution but both sides can see some benefit,' Dr Hakin said. 'It will be up to ministers, but early indications are they are prepared to listen to why it would be a good way forward.'

She added a two- or three-year deal from April 2007 could take in bigger changes.

The joint stance by the GPC and NHS Employers comes despite strong pressure from NICE, seemingly backed by the Department of Health, for new or tougher QOF targets next year.

GPs welcomed the chance to consolidate work on the existing quality framework, but said the global sum formula needed changing.

Dr John Canning, chair of Cleveland LMC and a GP in Middlesbrough, said the lack of an economies of scale factor was a clear 'downside'.

By Ian Cameron

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