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Gold, incentives and meh

Practices face £31k gap in QOF funding next year, claims GPC

GPs face a £31,000 gap in QOF funding next year unless they work much harder under the Government’s proposed contract deal for 2013/14, the GPC has revealed.

In a warning letter to practices, GPC chair Dr Laurence Buckman told GPs they should ‘look hard’ at their accounts and start planning so they can make ends meet next year.

The figures from BMA analysts show the average practice stands to lose £11,000 in QOF income under Government proposals for QOF thresholds to increase in line with the upper quartile of average current achievement, and achievement remains the same.

It also shows the average practice stands to lose £20,000 from the removal of the organisational points in QOF.

GPs will be able to earn back the money from this domain through new indicators introduced in QOF and a raft of new DES agreements.

But the GPC warned practices will not have time for the extra work, given that they are still expected to carry out much of the organisational work under CQC registration.

In a letter to practices sent out on Friday last week, Dr Buckman said that while the GPC is still awaiting confirmation from Government that they do intend to go ahead with imposing these changes on practices, but that they should start planning for the changes now.

He said: ‘The GPC is still waiting for confirmation of these changes but we know that practices need to understand now what is likely to happen to them so they can plan their services for next year and beyond.

‘If the Government’s plans do not change, and practices do not take on significantly more work, general practice could be seriously destabilised.’

The GPC has so far refused to negotiate with the Government on its proposals for the GP contract revealed last month, instead it is waiting for the DH to begin an official consultation with the BMA on the changes that is due to begin later this month and a DDRB assessment of GP pay next year.

Dr Buckman said that the threshold change alone is very likely to wipe out the DH’s proposed uplift in GP pay of 1.5%.

He said: ‘At this point we cannot assume there will be any additional investment in the contract at all…Although the Government’s proposals may yet be subject to change, now is the time to begin to plan for their impact.

‘In the coming months, all practices will need to look hard at their accounts and consider what changes will need to be made to make ends meet next year.’

A Department of Health spokesperson said: ‘Our proposed changes are not designed to remove any funding from primary care. Our aim is to drive up standards so all patients receive care consistent with that at the best performing practices.

‘Improving the quality of care we offer our patients is essential and GPs – like the rest of the NHS – must strive to meet new challenges and work in new ways. All money released from removing the basic organisational standards will still be available to practices who deliver improvements in patient care.’

 

For the average* practice:
 
Threshold changes - £11,000
Organisational points removal - £20,000
TOTAL QOF LOSS - £31,000
(*The average practice in England has 6,651 patients. Losses will of course vary according to practice circumstance and patient characteristics.)

Click here to read Dr Buckman’s full letter to practices

 

 

Readers' comments (10)

  • Basically this is a pay cut. If we were salaried GPs it would be transparent. The Gov. Is simply fiddling the books and cutting our pay. We are being targeted like public sector workers in Greece. In addition the Civil servants are trying to get pay back for what is perceived as an overgenerous contract in 2004.
    This is a clear case of professional victimisation .
    The BMA should organise non co-operation with CCG , revalidation . In short anything that won't harm patients but scuppers this government policies.
    Many practices will be unable to continue , many partners in their 50s will be throwing the towel in . No wonder they are trying to increase GP Registra numbers. We have a window of opportunity to torpedo the contract changes , we must do so now.

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  • It will never happen as GPs never seem to be able to galvanise into action - Sad but true -

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  • GPs did once organise themselves in the past and all wrote letters of resignation which were, I think, held by the BMA. The threat worked then and they did not need to resign. Forget not cooperating with commissioning, let's resign and have done with it. I'll be 57 in March 2013 and pretty soon any enthusiasm I have to stay on and add a little bit more to my pension will have been overtaken by the sheer despondency induced by successive governments. The days when GPs worked into old age because they enjoyed it are long gone it seems.

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  • already given up hope NI GP

    Some of us are not 57 and we have financial responsibilities to meet.Resigning is not an option.We are not contracted to carry out all these extracontractural responsibilities, disengage.......We are professionals/professional responsibilities/entitled to professional remuneration and RESPECT

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  • I think we should take a simple transparent approach, BMA calculates change in pay, taking into account pension changes, tax changes, contract changes and inflation. Appointments are adjusted by this number with no extras ALL other calls are told to goto a+e or transferred to 999.

    The key is changes that cost the health service overall. Not seeing routine patients probably saves money overall.

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  • People need to be informed how the changes will affect patients. The cold hard facts are that doctors will have to spend more time looking at how to maintain income in order to run a practice and look at other initiatives. It seems that simply caring for patients isn't backed with enough money to work.

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  • We do need to resign. We only get £4.00 per consultation. Please do the maths. We will do better privately. We can sell our services back like solicitors on legal aid £220.00 per hour. And we do not get at least £20.00 in hand per consultation privately we are not charging enough. Otherwise there is years of attrition ahead.

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  • I agree with James Bissett above.

    I have a young family, mortgage, and also responsibility my practice staff, I cannot just resign. I am aware this is why the government is able to hold us to ransom.

    Australia? What about my aging parents?
    Become salaried - even more job risk.
    Locum? Takes away the little I have left of the GP work I actually enjoy.

    May I suggest we take the government to European court of justice for enforcing in achievable target and in humane long working hours.

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  • Just another strategy to turn us into a salaried workforce....it's coming and patient care, especially inner city care, will be going to the dogs.

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  • GP's have practice managers who deal with admin work etc. but it does appear that practice managers have the power to give / decline appointments to patients on their whim.

    I also feel we need to remember that although some doctors think they are 'God' they are actually only human beings, they have families, some are single parents. If we want the best from them we need them to be fit and healthy healthy, to be in the right frame of mind to deal with a heavy days work.

    Perhaps the real need is to educate the public in how to deal with minor health issues rather than go running to A&E because they have a minor cut or splinter in their hand!

    Outpatient clinics close at 5 p.m. why not use the the facilities as drop in centres, with all the services in one place, no extra staff needed, no additional buildings, no additional heat/ light / phone bills, council tax on other buildings etc. Close A&E as we know it, making access via 999 ambulance services only, use 'out-pateints' as triage centres thus reduce costs fro other buildings all around towns.

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