Department of Health publishes details of proposed GP contract changes and paves way for imposition
The Department of Health has launched a 12-week consultation on its proposed changes to the GP contract ahead of a possible imposition – and has revealed it plans to distribute any funding uplift next year unevenly between practices.
The DH, which had previously offer a 1.5% uplift in GP funding, said that any uplift would now be decided following recommendations from the Doctors’ and Dentists’ Pay Review Body in February.
It said any overall would be ‘distributed in a way that gives some increase to all GP practices but is targeted towards those with less current funding per patient’.
The DH also announced the investment of up to £10m annually in two new GP-led vaccination programmes for rotavirus and shingles.
As expected, the DH is pushing ahead with changes to the QOF, raising thresholds, removing £164m in funding from the organisational domain and introducing new indicators recommended by NICE.
The DH admitted this would create more work for GPs to achieve the same amount of funding.
It said: ‘This means GPs will be delivering more to retain the money they were getting under the old organisational indicators. The NHS Commissioning Board will develop more detailed specifications for these new schemes.’
Plans to phase out the MPIG over seven years are also included in today’s consultation.
The GPC and other stakeholders have been given 12 weeks to respond to the consultation, after which the changes could be imposed.
Responding to the announcement, GPC chair Dr Laurence Buckman said: ‘Practices are already under huge workload pressures and we have real fears that these proposed changes will result in an even greater load at the same time as forcing through a reduction in core funding. The Government’s proposals may sound attractive on the face of it and some of their suggestions are good, however they have not fully considered the overall impact on practices of all these changes being implemented together.’
‘The BMA will closely analyse the details of these complex proposals. We are open to real dialogue with the government about the impact of these changes as part of its planned consultation. We hope that ministers intend to engage in a meaningful discussion and that they will listen and act on concerns that are raised, particularly where their proposals are unworkable or will lead to unintended consequences. We would be extremely disappointed if this consultative process was a rubber stamping exercise for their existing plans.’
The changes in brief
The main changes proposed in the consultation letter include:
- The Minimum Practice Income Guarantee will be phased out over seven years as part of the contract.
- Any overall increase in the value of GP contract payments, which will be decided following recommendations from the Doctors and Dentists Pay Review Body in February, will be distributed in a way that gives some increase to all GP practices but is targeted towards those with less current funding per patient.
- All recommendations by the National Institute for Health and Clinical Excellence (NICE) for new and improved indicators to the Quality and outcomes Framework will be implemented in full.
- QOF reward thresholds will be increased so that more patients benefit from the best evidence-based care that can help to save lives.
- Organisational QOF payments will be discontinued releasing £164m which will be used to help fund improvements in patient care through the implementation of all the NICE recommended changes and the commissioning of extra services from GP practices.
- It will stop some GP practices receiving thousands of pounds more than others that care for a similar number of patients with similar patient needs.
- The extra services to be commissioned from GP practices will cover: 1) improving the assessment of people with dementia 2) improving care management for frail older people and other high risk patients at risk of unplanned hospital admissions 3) using technology to help monitor the health of people with long term conditions and improving online access to services.
- This means GPs will be delivering more to retain the money they were getting under the old organisational indicators. The NHS Commissioning Board will develop more detailed specifications for these new schemes.
- The Department of Health is proposing investment of up to £10 million annually (depending on take up) to GP practices for two new vaccination programmes for rotavirus and shingles.