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Independents' Day

GPs 'stunned' by contract changes at first roadshow in England, says GPC

GPs were ‘resigned and despondent’ at the first of several GPC roadshows in England discussing how practices can cope with the contract changes set to be forced on them from April.

The GPC roadshows have been running in Wales and Scotland over the past week, but the first in England took place in Worcester last night, chaired by negotiator Dr Peter Holden.

Journalists were banned from the event by the BMA, but Pulse has learnt that around 150 GPs attended and that they were told they must become more business-savvy and only carry out the parts of the contract which are financially viable.

The message echoed the advice from GPC in December when it wrote to doctors telling them to consider the value of each QOF point before taking on any new work.

Commenting after the event, Dr Holden said: ‘I think some of them were quite stunned at the financial losses. GPs need to learn to look at what is being asked of them, and ask is this in the best interest of the patient, clinically and professionally, and then is it in the best interest of my practices.

‘It is time the profession learnt that we are independent contractors, we are not obliged to work at a loss. People must stand up on their own two feet. You stick to your terms of service, you stick to your contract, but remember the QOF for example is voluntary.’

Dr Grant Ingrams, a GP in Coventry who attended the Worcester event, said: ‘It was a useful networking experience. I saw a lot of colleagues I had not seen for a long time. Did I learn anything new? Not really, but it was interesting to hear what other GPs think.

‘I noticed a certain resignation and despondency. Anyone over 50 I spoke to was thinking about their pension, when they can afford to get out. The risk is that we end up with no GPs, and that is going to force the service to change beyond recognition.’

Readers' comments (6)

  • Why are the GPC not suggesting coordinated action? We have a powerful negotiating weapon that we seem to be ignoring. A co-ordinated resignation of Practices from their CCGs would have no effect on patients or Drs but would cause apoplexy in Government and Whitehall. It is surprising that GPs who have been coerced into Commissioning (neither us nor the public have been democratically consulted about this enormous change to the NHS) are not now questioning whether we wish to continue our involvement. Why should we help Government with their NHS rationing difficulties? Mutual back scratching is OK but when they start whipping your back most people start to withdraw favours. The Government cannot allow the Commissioning Project to fail. But they have forgotten that CCGs are membership organisations. The New (imposed) Contract says we all have to be members. If we refuse to sign + write letters of resignation from each Practice to CCGs political chaos will follow - the Government will be forced back to the negotiating table. The public will not be affected and will have no understanding of what is happening. We will not be seen to be complaining about money just reconsidering the flawed nature of the Health Bill proposals.
    It is not illegal - if GPs decide they no longer wish to be members of CCGs they do not have to give reasons or justifications. If they all decide at the same time and the GPC help co-ordinate then that is simply facilitating bureaucracy of the en masse change of heart. If someone thinks it is illegal then let them argue that out in Court - they will not dare - imagine the Government having to take GPs en masse to the High Court to try and enact their Health policy .
    It is important to emphasise that this is not a debate about pros + cons of Commissioning, this is not a discussion re money THIS IS A POINT OF PRINCIPLE - We are Professionals who have negotiated in good faith and do not wish to be treated as we are now or ever again in the future. If we do not stand up strongly and deviantly to bullying tactics we will continue to be bullied.
    Shame on the GPC for not actively consulting grassroots GPs on this potential positive, easy, brave and politically powerful proposal. But there is still time. Stand up, stop moaning and start calling for a boycott of Commissioning if negotiations are not reopened.

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  • I can't think of anything more self-defeating than refusing to work with CCGs. For the first time ever we GPs have the ability to shape the NHS and its delivery of healthcare. If we fail to take up this opportunity. It will be shooting ourselves not just in the foot but in the head - and the NHS with it.

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  • I feel like being bullied into doing things with these unilateral changes. It is clear the governament has no respect for us.
    My suggestion would be dont bother with efficiency saving,.. just refer every patient with joint pain to orthopaedics and every diabetic to diabetes clinic for a month
    It wont effect patient relationship --but definitely will effect the government who are anyway planning to destroy us

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  • Anon at 10.09,

    I'm sorry but you are being rather naive. The new CCGs will have very limited power to make useful, meaningful changes (constrained b budgets and the overarching CB). However, they will bear the full brunt of things when things go wrong.

    How empowered do you think the CCG in Lewisham feels about their top-down hospital closure?

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  • "commissioning" is a Machiavellian device picked up by the last Government from private consultants .It is expensive does no clinical work but is a perfrct vehicle to fracture finally the primary care independent contract.The current government have now pulled off an ice cream to Inuit stunt. GPs given a flat pack Komissioning Kit containing their own coffin ...and being allowed to assemble it themselves. The alarming thing in this thread is anonymous support for the idea.
    Free care for chronic illness is not a viable business model.Unless money is leveraged from
    Independent contractors and donated as profit to the private sector . The I hereby bias in the budding process ensures the bulk of budget allocation goes to large private sector groups . Many of these are multinational and have as much interest in the welfare of the UK chronically unwell as G Bush has in the collected works of Shakespeare. Shambles doesn't get near to describing this state of affairs.

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  • Siraj Shah

    Instead of moaning and groaning let us unitedly take some action that will not affect patient care but will drag this unholy Con-Lib alliance to the negotiating table. A) Be prepared to send mass resignation letters to the CCG's.
    The ever growing demand from our secondary care colleagues to carry out unpaid tasks like investigations; re-cycle referrals etc. creating enormous workload for the practices- effectively using GP's as their SHO's to save money. One of the examples of such unpaid work is when a psychiatrist sends out a fairly long letter to the GP..."I have commenced your patient on atypical antipsychotic please do a FBC, LFT and ECG. Such delegation of clinical work from secondary to primary care cannot be in the best interests of our patient care, the psychiatrists should carry out these investigations before commencing patients on an atypical antipsychotics and follow up by a repeat ECG etc. B) In response to such requests from the secondary care practices should draft a standard letter to say “ independent contractors we are not obliged to do any unpaid work therefore the responsibility for carrying out such tasks goes back to person who initiated the request. A fundamental principle of safe and good clinical care is the doctor who sees a patient and initiates an investigation is also personally responsible for its follow up and any actions required. Off course follow up investigations etc.when clinically indicated following a hospital discharge will always remain our responsibility.

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