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Gold, incentives and meh

In full: BMA response to GP contract offer

Read the full response from GPC chair Dr Laurence Buckman to the Department of Health’s announcement on its proposed changes to the GP contract

‘The implications of the Government’s new proposals for general practice are likely to be huge, and we will be examining the consequences of this threatened imposition so that we can fully inform the profession and public as soon as possible. There are serious question marks over whether some of the intended changes are based on sound clinical evidence or are practical or feasible.’

‘The Government is being disingenuous in its presentation of how we have arrived at this point. GPs will be stunned and angered that the government is disregarding five months of detailed negotiations between the BMA and NHS Employers which was in its final stages just a couple of weeks ago. The Government must urgently rethink its approach and return to our negotiated settlement that was so close to being concluded.’

‘The Government’s own surveys show that patients consistently recognise their GP’s commitment to their patients. Doctors have always been at the forefront of driving up standards and we do that by responding to sound evidence, not ill-considered quick fixes.’

‘Many practices are already stretched to breaking point, which the Government appears to be ignoring. For all practices, the changes will place an enormous strain on GPs at a time when they are struggling under the weight of a wholesale NHS reorganisation, especially the implementation of CCGs.’

‘Doctors recognise that we are in tough economic times and the BMA has been committed to achieving a negotiated settlement that delivers genuine improvements for patients while being realistic about what practices can deliver.’

Readers' comments (4)

  • I've got an original idea....

    Why don't we get paid for the ACTUAL work we do (consultations), ACTUAL services we provide and ACTUAL quality we deliver!

    After all it IS the way every other small business in the world is resourced.

    Why the GPC insist on flogging a flawed formula based of the POTENTIAL workload POSSIBLY generated by a VIRTUAL weighted patient, is beyond me.

    The GP's posting above are concerned about spiraling demand and workload.

    Would any other small business moan about having too much work?

    NO, because they'd get paid for doing it!!!

    The insistence on funding a core contract based on potential rather than actual workload is ludicrous in the extreme, and actually creates perverse incentives which have the potential to drive down quality and access. Even QoF rewards the achievement of targets, no matter who does the work.

    If the government want GP's to do more, they have a funny way of showing it!

    Primary care is the most cost effective way of delivering health services, the DH know it (Commissioning excellence in Primary Care) and so do we. Even the Kings Fund have recognized the benefits of enhancing Quality in primary Care and suggests government pay special attention to incentivizing this.

    Why not then, facilitate growth, innovation and leadership by ensuring GP’s can rest assured they’ll be paid for the work they (or their staff) do.

    Dame Barbara Hakin’s recent letter charts the destruction of all the above objectives.

    General Practice will be in decline and the NHS and, more importantly, our patients will be worse off for it!

    I use the NHS income my practice receives to deliver ACTUAL services not to compensate me for POTENTIAL demand.


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  • Let us be paid for actual work rather than potential workload - Let each consultation, telephone appt, repeat script, nurse appt, and admin work from hospital be priced. Private GP`s charge £90 per consultation. I do 36 consultations per session. Even if they paid £15 /consultation i will earn more than what I earn now.
    GPC please consider a HRG code for each activity in primary care and we will charge. If GP`s walk out of NHS, our workload will decrease and we can maintain our income as Dentists did.

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  • Sorry guys I disagree.

    We are able to operate without worrying about if my conscience is clear because of the block contract. I cannot tell a mom to bring back her pyrexic child at end of my surgery if I knew she (or the nation) had to pay for it. Nor can I propose to see my depressed patient sooner than usual 4 weeks. Nor can I see my heart failure patients to come back in a week after increasing the diuretic.

    In fact we'll be under more pressure to refer the patient as soon as they walk through the door, W&W tactic would become unacceptable and they'll want to be given a broad spectrum AB every time to avoid coming back.

    P.s. I can't understand how the poster above can do 36 consultations in a session. That's 6hours of consultations without break, even if you run every consultation to time

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  • A contract is just a fair way to ensure the Tax payer gets value for money and the the commissioner can get a fair return for the work done.

    What is not working at the moment is and I'm sure I'm not alone is the fact I remain over stretched.
    I can not keep up the current pace both for my sanity or the safety of my patients.

    Let's get back to honesty and integrity in our dealings with the Nhs employers and them with us.

    The only way forward is to say no
    Or let's face it , to consider a mass resignation and taking the whole profession private.
    Before you all jump up and down..I know I want to do more for my patients I'm sick of fighting fires Turning patients around in a factory style process to meet targets arbitrarily set!

    If they want to take money away and give it to others
    They are welcome to
    We already runs services below cost and below any reasonable cost that a private sector company could deliver it for

    Sorry for the rant!

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