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Opting in may split practices

Dr James Graham is predicting the new contract could spark partnership disputes over optional services.

Dr Graham, who practises in Liverpool, said he and his three partners expected to reach agreement on whether to opt into enhanced services such as minor surgery and treating drug misusers.

But he expected the decision to prove contentious in some less harmonious practices.

'If you've suddenly got lots of GPs saying they want to specialise that may make day-to-day practice even more pressured,' he added. 'In the short-term, that might exacerbate a workforce crisis. The idea is that you can replace people with locums. But in most inner-city areas locums are like gold dust.'

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