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Independents' Day

Buckman: Practices won't have time to take on DESs

Exclusive GPs are likely to take a pay cut rather than implement all the four directed enhanced services the Government is proposing from April, as the workload involved will be ‘very steep’, says GPC chair Dr Laurence Buckman.

Dr Buckman said there was ‘nothing wrong’ with the four DESs themselves, but the Department of Health would reduce patient access to GPs by forcing the additional work on GPs without any additional funding.

The impending GP contract imposition will offer four DESs - worth £3,600 each - to GPs in England to incentivise dementia case-finding, developing access to online GP services, telehealth and case-managing patients at risk of hospital admission.

The DESs are funded by the removal of organisational QOF points, and if practices decide not to take them on will result in them losing a sizable chunk of their funding at a time of rising practice expenses and a raft of new QOF work also set to be introduced from April.

The admission comes after accountants advised GPs to cut their drawings by up to 10% before the expected contract imposition.

Dr Buckman said: ‘The obvious unintended consequence [from pushing through the contract changes] is that people won’t do the DESs that the Government so desperately wants them to do. There is nothing wrong with them as individual DESs, if you look at them and their subject matter.

‘The unintended consequences are going to be reduced access. The DESs, some of them, they won’t fall flat, I am sure some people will do some of them somewhere, but I guess a lot of people will not take on all four DESs. I am not sure actually you could take on all four DESs. The workload of all four is very steep.’

Dr Buckman made the comments in an exclusive interview with Pulse, where he defended the GPC’s handling of the contract negotiations and admitted the DH ‘holds all the cards’.

He said: ‘You can’t block what governments decide to do. There are many things governments decide to do that I don’t agree with, or indeed that the vast majority of the population doesn’t agree with. But that doesn’t mean they don’t happen.’

‘Now what we have to do is make sure that GPs are as equipped as they can to cope with what is coming, that we can do our best to diminish the damage that the deal, as imposed, will put on doctors.’

He also said there was ‘no point’ in industrial action or any boycott of commissioning, even though a Pulse survey found 52% of the profession would support it.

He said: ‘Some of us suspect that the Government may not actually mind terribly much if GPs did not take part in commissioning, so we may be playing into their hand by saying: “Well then, we’ll stomp off the pitch.” Who would take over? It sure won’t be GPs.’ Watch the full interview here

The comments come as the BMA urged GPs to get involved by submitting their own responses to the Government’s proposed deal directly to the DH. It also launched a tool for GPs to calculate exactly how much funding they face losing from the proposed changes to the QOF.

Readers' comments (23)

  • Thats great leadership from the BMA.

    In summary. We can't do anything about it, no point even trying. Just take a pay cut, take a pay cut, run Commissioning groups and work harder.

    Any GP in their 50's should seriously look to taking early retirement.

    Any young doctor, DO NOT DO GENERAL PRACTICE.

    Any young GP's, this is just the start of the dismantling of General Practice. Keep ticking the boxes!

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  • Peter Swinyard

    Having read the full "consultation document" I do wonder where I am to find time in my 12 minute consultations for the patients' agenda. Ticking the boxes, doing the QOF and asking late middle age patients if they are going doolally will take up most of that time. Is the government aware of this and do they really want a patient-centred NHS as they claim? Would I pass the Friends and Family test if I insisted on doing a MMSE on a gentleman of retiring age who came in with gout? Let's campaign for patient-centred general practice, with good continuity of care and try to help politicians to understand the long term good this will achieve.

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  • Just to correct the above post, BMA is trying to do something (or at least collecting opinions). It's the GPC that seems to have given up.

    It is tragic we have such a weak leadership at the GPC at the time of need. Instead of having Churchill, we seem to have Gordon Brown on our hands....

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  • Look back in history, this is how dictatorships grow. The people who can do something right at the start don't and only wake up to the fact that this is not going to turn out well when it's either too late or getting it changed/stopped/reveresed is so so bloody. As a patient, I am scared, as a father, I am terrified.

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  • 'case-managing patients at risk of hospital admission' - if they're not already doing this, it's no wonder our hospitals are overflowing.

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  • The government can bully us-true. But one thing they can't do is make doctors go into General Practice or stay in General Practice. THIS WILL ULTIMATELY TRIGGER A MASSIVE RECRUITMENT CRISIS THE LIKE OF WHICH WE HAVE NOT SEEN BEFORE. What will they do then??-I suspect they will devise a junior doctor quota system forcing doctors into GP land against their will and The Daily Mail will run a campaign demanding that doctors are made,against their will, to become GPs.

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  • "The obvious unintended consequence [from pushing through the contract changes] is that people won’t do the DESs that the Government so desperately wants them to do. "

    Disagree - may well be intended & next brick in the wall. "Oh, GPs have said they can't manage these really important DESs so they're forcing us to privatise this work instead - unfortunately we'll need to give private companies more money to incentivise them."

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  • Time for a new general election I think. Time to remove the con dems from government and any of their stooges in primary care. Th

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  • After Major, the Tories were unelectable for Over a decade. In the next election they will be gone again. The continuation of the current government is hazardous to public health and sounds like a new election needs to be called. Labour and the good liberal democrats here this, stand up and be counted!

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  • I thought the last lot were bad, but now I think they were perhaps just ignorantly misguided. This current lot are just plain blind and deaf to see what needs to be done or to listenining to those that know i.e the people working in general practice. I have to apologise now to you all, as I voted for them - never again!

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