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Independents' Day

No need to assess impact of contract changes, says DH

There is ‘no need’ to assess the impact of wide-ranging changes to the GP contract, including the widely criticised dementia DES, the Department of Health has said.

The DH said that no part of the proposed contract changes require an impact assessment. This followed an enquiry from Pulse into whether the Government will be assessing the impact of the proposed dementia DES on patients.

A DH spokesperson said: ‘There is no impact assessment – the annual GP contract changes do not require an impact assessment. There will be ongoing consultation about the changes.’

Dr John Canning, GPC member and a GP in Middlesbrough, said the Government has a duty to produce an impact assessment for all the changes. ‘I am not sure what the formal rules say, I suspect the DH is probably telling the truth, but of course [the contract changes] need an impact assessment because the impact is what we are telling them the problem is,’ he said.

He added: ‘The impact that we think this is going to have on existing services is much wider than the dementia screening. It will impact on GPs’ time and availability. It isn’t just about dementia – if anything, this is the tip of the iceberg. It is going to have quite an impact on practices if they find that they are going to be unable to manage services.’

GPC member and Birmingham LMC executive secretary Dr Bob Morley added: ‘Of course DH should be doing an impact assessment on the whole of the new contract, but even if they did it would just be an incompetent whitewashing job.’

Commenting on the dementia DES, he added: ‘This ill-thought through DES has been brought in for political purposes only.’

‘I hope the GP profession will do the right thing and vote with their feet over it. It will cause more harm than good, including a great deal of avoidable stress and anxiety to our most vulnerable patients and their families. And quite simply there are not the services or resources to cope with the potential fallout of this scheme.’

Dr David Wrigley, also a GPC member, and a GP in Lancashire, said: ‘Surely to roll out this dementia DES with no impact assessment goes against everything the NHS believes in - that evidence based medicine should only be used when treating patients. I know my memory clinic service is under significant strain due to the increased usage of its services and who knows what this untried and untested DES will do to our local NHS service.’




Readers' comments (4)

  • I seem to remember a little report last week criticised a hospital trying to be a FT , for making financial decisions without assessing the impact such decisions may have on patient care and safety. Or have I forgotten like the DH did with the recommendations of the Kennedy report et al?

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  • The purpose of the contract changes is to reduce GP income .
    The purpose of the health and social care bill is to shift responsibility for rationing away from politicians and accelerate privatisation of health provision .
    The impact of these changes from the point of view of the department of Stealth is entirely predictable and therefore needs no asessment

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  • Gary Young

    Ha, there was no need to assess impact of Health & Social Bill either and DH blocked release of the risk assessment. With hindsight, earlier and honest consultation, shared understanding of the imposed changes and assessment of the likely outcomes might have been very useful indeed. I imagine DH don't want an impact assessment of the GP contract changes because then the profession and the public would see what the changes are intended to achieve. If DH don't do an impact assessment, perhaps the BMA should commission the work to be done independently?

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  • One of the other DESs the DH is about to impose relates to Telehealth - with the first LTC to be considered being Hypothyroidism.
    I agree - this is blatantly a GP practice income reduction exercise: can anyone think of a use for Telehealth in hypothyroidism?

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