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Points will become more lucrative as years pass

The average GP will be able to earn a maxium quality payment of £26,250 in the first year of the scheme.

But the amount up for grabs for a GP with an average notional list will soar to £42,000 the following year as the cash value of points rises dramatically.

The contract has priced the value of a single quality point for an average three-partner practice with a weighted population of 5,500 at £75 in 2004/5, rising to £120 in 2005/6.

An average three-GP practice scoring the maximum 1,000 points, plus the bonus 50 points for 48-hour access, would earn £78,750 before expenses in 2004/5 and £126,000 the following year.

GPC negotiator Dr Andrew Dearden said practices that remained at the same level of points in the second year would see their quality pay leap 60 per cent without doing any more work.

It would be up to the practice how much to spend on staff and resources but most already had the systems in place, especially for conditions such as coronary heart disease, he said. 'There is a certain amount you need to spend to set up the processes. But once they are there it becomes an economy of scale.'

It is unclear how PMS GPs will tap into the quality fund. Dr Hamish Meldrum, joint-deputy GPC chair, said: 'That is yet to be decided ­ this is a GMS contract.'

Every GMS practice will receive preparation payments for three years from 2003/4 to help them establish a baseline quality achievement.

These payments will

average £9,000 per year for a practice of three partners.

From 2004/5, practices will agree with their primary care organisation how many quality points they aspire to. Monthly aspiration payments will be made, totalling a third of the full payment. For example, a practice aspiring to 750 points in 2004/5 would receive 250 points' worth of cash that year. The achievement payment, made at the beginning of 2005/6, would make up the remaining two-thirds.

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