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GPs asked to deliver 'twice the efficiency savings' as other parts of NHS, says NHS Alliance

The proposed GP contract will lead to GPs delivering at least twice the efficiency savings of other parts of the NHS, the NHS Alliance has warned.

NHS Alliance GP Network lead Dr David Jenner urged the Government to consider the impact the contract proposals will have on GP workload. He argued in a blog post that practices are being asked to do much more for the same or less than other parts of the NHS, with GP services already cash-limited while hospitals continue to be paid by results.

In the NHS Alliance’s response to the Government’s consultation on its proposals for the 2013/14 GP contract, Dr Jenner also urged the Government to hold off imposing QOF changes until all read codes, business rules and guidance are in place. They said this should be done by April or, since this is unlikely, be deferred to later in the year.

The GPC has said the average practice stands to lose £31,000 from QOF changes alone.

NHS Alliance further raised concerns over Government plans to change the allocation formula by removing the MPIG over seven years from 2014/15 and rejigging the Carr-Hill formula to take into account deprivation. The Alliance said any changes to the formula should be widely consulted on before being imposed.

Dr Jenner wrote: ‘Yes, the country is facing challenging times, but the threatened imposed contract would appearto set general practices a much stiffer efficiency target than the 4% the rest of the NHS is facing - indeed the secretary of state admitted GP practices were seeing 3.7% more activity at last year’s NHS Alliance Conference.’

‘With 15% of QOF also becoming core contract policed by the CQC, and having to be re-earnt through a series of DESs that are weakly evidenced at best, I estimate general practice is being asked to deliver at least twice the efficiency savings of other parts of the NHS, whilst being asked to do more and more, including commissioning the vast majority of health services through CCGs.’

Dr Jenner added that medical accountants were warning of a 10% reduction in drawings, increased pension contributions and ever dwindling limits on tax free pension contributions. This led to a ‘perfect storm brewing for GP recruitment and retention’, especially when taking into account the introduction of the CQC, revalidation going live and enforced membership of CCGs. ‘Add in a move to four year training for GPs, and very soon I fear we will face a pre-2003 scenario again of a crisis in the GP workforce,’ he said.

He said: ‘General practice is at capacity now, much more will break it. Could this be the plan? Or is it just the unforeseen consequences of a series of policies that have not really been thought through? I’m really not sure!’’

Click here to read the full post from Dr Jenner


Readers' comments (5)

  • Vinci Ho

    It is an attitude problem , isn't it?
    The government would say ,' I don't give a damn about you guys moaning about money and workload all the time .Here , take it or leave it , This is the way , no more fuss!!'
    Does not help when PULSE magazine branded our GPC leader as ' the leader of a defeated profession '
    But I suppose that is true ............

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  • Where has he been regarding the introduction of changes in QOF?
    The development system is *designed* to make sure that there is no possibility of GPs being able to get on top of the current year's QOF!
    Decisions are made immediately before the end of the previous year - whether negotiated or imposed.
    The first draft version of the Rule-set is issued in June (but not allowed to be used for GP IT support) and the final version (for use by software suppliers) in early December.
    Oh just read my blog - - for the details!
    *This is not anything new - it is built into the DH system* - so I'll ask again - for those of you who *don't* read my blog - is the *system* designed to save the DH money by frustrating the efforts of GPs to jump through this year's hoops? or the alternative (which I find even more scarey) is DH incapable of thinking through the effects of the time-scales it imposes?

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  • andrew Field

    Nice blog Mary. You're not paranoid. In fact you're rather generous to even allow the reader to consider the possibility that it's not all about setting us impossible targets to claw money back. I'm in a reasonably high achieving practice but we expect to take a hit. I'm sure less efficient practices will be severely compromised and I think it's a lot to do with a push for more corporate number crunching super-market practices. How miserable!

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  • Harry Longman

    Dear GPs,
    I'm sorry life is tougher for you, but you must have known when you signed up to the new deal that since the dawn of history all incentive schemes have got tougher and the rewards less. Now it's happening that is no surprise. But look down: you aren't closing like the high street is closing, you aren't being made redundant like NHS managers, you aren't struggling to find work like most small professional businesses.
    And instead, do something to make your practices better for patients, better for you and more profitable too.

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  • Dear Harry, You obviously have little or no idea what a GP Practice does and seem to be just someone else working for compare the market dot com. I have been a Practice Manager for over 18 years and should not have to justify either my employers or my right to equitable pay and conditions. The only thing in your entire statement that could be compared to General Practice are the words "small businesses" We are just that, but now find ourselves working for little or no profit to reinvest. We do not struggle to find business but struggle to achieve the ever demanding political targets that ramp up the unnecessary business. We are expected to do this with ever dwindling resources. And yes we are now looking at redundancies in our current workforce and an ever increasing workload. And let me assure you we are at breaking point. Thanks for your tip regarding making ourselves better for our patients, perhaps if I felt you really understood what we did I could give you a few pointers that told you how to improve also.

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