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Independents' Day

GPC tries to limit damage to practices as contract imposition looms

The GPC has warned practices to prepare for the biggest funding cuts in the history of the new GP contract, after admitting it can do little to stop the Government imposing sweeping changes.

Negotiators have asked economists to model the likely impact of the changes, and will hold roadshows and survey GPs early next year as they prepare to respond to the Department of Health’s formal consultation.

They are also set to resume meetings with the DH over the changes, but said their focus was now on ensuring the impact of any imposition was ‘as minimal as it can be’.

The DH began a 12-week consultation on its proposed deal last week, clearing the way for an imposition in April. In a 37-page letter, it set out in detail the raft of new QOF work that practices will be asked to take on, and outlined four new directed enhanced services that will be funded by a 10% reduction in the size of the QOF.

The DH also announced vaccination programmes for rotavirus and shingles and preparations for the phasing-out of the MPIG from April 2014.

The DH said a series of meetings with the GPC were scheduled over the next few months and it hoped negotiators would attend.

GPC negotiators said they would take part in the consultation, which they warned must not be a ‘rubber-stamping exercise’, but cautioned practices should expect the worst.

GPC chair Dr Laurence Buckman said: ‘The GPC always engages with consultation. That is the way we ameliorate an imposition. My duty is to ensure that the imposition is as minimal as it can be.’

Asked if the GPC could realistically expect to block the imposition as a whole, GPC deputy chair Dr Richard Vautrey said: ‘No, I think there will be some contractual changes for 2013/14. We would hope to convince the Government that all their plans, taken as a whole, are not deliverable. We would hope that they would listen to the concerns from the profession.’

GPC negotiator Dr Chaand Nagpaul said: ‘This is basically the most significant quantum reduction in the GP contract that we’ve ever seen since the new contract. You’ve got a double whammy of defunding the contract and then piling on more work.’

The GPC said it would organise roadshows around the country to explain the impact of the DH’s proposed deal and seek the views of the profession through a survey early next year, although it was too early to say what questions GPs would be asked or how it could use the results.

Last month, Dr Buckman told LMC secretaries at their annual conference that a boycott of commissioning in protest at the contract changes ‘wouldn’t work’ because too many GPs were already involved in commissioning.

Dr Ivan Camphor, Mid-Mersey LMC secretary, said some LMC secretaries had unofficially discussed calling an emergency LMCs conference, although no plans had yet been formulated.

He said: ‘Everyone is fed up with doing more for less. We are working from 7.30 in the morning to eight or nine in the evening. There is a huge amount of unrest, anger and frustration and it is not going to go away.’

Dr Rob Barnett, chair of Liverpool LMC, said: ‘If you want to destroy general practices, this is the way to do it. It is not workable.’

Readers' comments (20)

  • Azeem Majeed

    I wrote an editorial in this month's BJGP about the financial challenges facing GPs in England. It was submitted some time ago, so I wasn't able to include a discussion of the more recent developments. See for a link to the article.

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  • its going to implode but perhaps that is what they want ?

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  • Go for it Ivan, somebody needs to represent the "unrest,anger and frustration" of the grass roots given that our national representatives seem out of ideas.

    I may be unduly pessimistic but I don't feel that the DOH will be too bothered by a "roadshow"

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  • Quite agree with anonymous at 11:50. This is all part of the plan to get rid of current model and sell it off to big corporates for cheap.

    If patients think they can't get good health care now wait till that happens........

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  • what i would like GPC to do

    1) agree funding model is a mess with pms, gms and mpig resulting in different funding for all
    2) offer negatiation on new one size fit all funding formula, getting rid of pms, mpig
    3) Do take into account that mpig represent a previously existing funding stream which was there for a reason, i.e to compensate for rural area, having branch surgeries etc, so the new formula needs to take account of all that again
    4) Advice all practices to "take the hit"of reduced qof, do not accept new work for the money on offer and then negotiate more realistic funding for the additional work taking into account money lost and additional time required to implement new changes. Make a stand and cut our losses now, otherwise this will continue to happen again and again. it might give us a stronger ngotiating postion in the future.
    5) Publicity and action can then focus on the fact that we have been forced to have a paycut, with the offer for additional work for (not enough) additional monay being dealt with as a separate issue

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  • Vinci Ho

    Further to what Rob said , this the beginning of the end of general practice in this country.
    If you can tolerate this , the government will assume that you can tolerate more and more. The tank can roll on to destroy everything we know .
    Mr Hunt, well done, mission accomplished .
    This message will self destruct in five seconds

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  • Perhaps the very best action GPs could take right now is to unilaterally and universally pull out of any CCG Board positions and workstreams until they have an absolutely clear position that Practices will not be undermined.

    The GPs first duty is to the patient but he can only do that if he is a viable Practice to work from.

    Come on - less of the tosh about roadshows (thats just 'free lunches') and no more tokenistic 'days of action'.

    This is one way (I would argue the only way) to get the DH and Policiticians t(and maybe even the GPC) to sit up and take notice.

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  • Dammed if you do dammed if you don't do work - it is all very well to say don't do work that is unfunded but this year of all years is not a good time to be doing that as you will as commissioners be looking not to send patients back to hospitals - so if the practices win the ccg lose - unfortunately if you are in general practice that is you on both counts

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  • Nhsfatcat

    One of the reasons we'll be walked over is that we all 'struggle' on to do what we can for the patient(s.) Let's face it- are we trully exposing the patient to the primary care mess? No we shield them from it - do our QoF Qip and whatever needed to run a practice when we should be with our families, resting and preparing ourselves to undertake another day of dealing with sick, dying, worried, distressed and frightened people (and partners.) So we are not doing our best for patients by feeling tired, burnt out and not believing in the system we're delivering.
    We aren't standing together and being honest with the public.
    (I'd also not allow anonymous comments- be brave stand up for yourself, practice and patients.)

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  • Many of our local GP,s on CCGs are either on the way out of general practice or have now left so action to boycott will be ineffective. Locally there is an unprecedented 5% vacancy rate which is likely to rise soon and is seriously of concern.

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