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Revealed: How GPs narrowly avoided access targets in new GP contract

Exclusive The GPC countered attempts by the Government to include out-of-hours responsibility and longer opening hours in the GP contract, according to the GPC chair.

Speaking in an exclusive interview with Pulse, GPC chair Dr Chaand Nagpaul said negotiations in a ‘pre-election’ year were particularly tough with the Government wanting to add ‘a huge amount’ to the contract.

Asked whether the contract would help to relieve pressures on GP practices in the short term, Dr Nagpaul admitted that the ‘overall pressure’ may not change much but said that the success of the negotiations should also take into account ‘what is not in it’.

The agreement, announced this month, will see few changes to the contract, with the most notable points including a rolling over on the avoiding unplanned admissions DES, a named GP for every patient, increased funding for maternity and paternity cover and practices publishing their average earnings.

But it comes at a time when the Government is emphasising its commitment to increasing access to primary care, which includes a promise by Prime Minister David Cameron that all patients will have seven-day access to GP services by 2020.

Dr Nagpaul told Pulse that getting the Government to agree to only small changes was a tough negotiation. He said: ‘What is also important to recognise is that in a pre-election year there was a huge amount that the Government wanted to add to the contract, and we managed to push back on most of that. So what we have is a contract that should be judged as much by what is not in it as what is in it.

‘I can assure you that there is no way that this contract that we got reflects the wish of Government. We negotiated very hard to make sure that we did not agree to elements that would have added further workload, and more misery, for GPs.’

When asked what the Government had pushed to include in next year’s deal, Dr Nagpaul said that the fact GPs are not taking on extended contractual hours or out-of-hours responsibility ‘speaks for itself’ in light of the Government’s agenda for increased access.

He added: ‘The fact that we are here today with a contract with hours of availability that have not changed I think speaks for itself. I am not responsible for out of hours, those arrangements have not changed. We know the Government has a strong agenda for access – none of that is in the contract. We have actually managed to stem many elements of what the Government would have liked.’

Asked how the GPC was able to refuse the Government, Dr Nagpaul added: ‘I was very straight with the Government. I asked them to open their eyes and look at the facts in front of them. We have a situation where the Government’s own commissioned studies are talking about a workforce crisis. We have seen a 15% drop in young graduates choosing general practice as a career. We are seeing practices closing, younger doctors emigrating, leaving.

‘All I did was tell the Government: “look at this picture in front of you, and you have a choice of action – of making this worse and seeing the whole of general practice collapse, or you have a choice to stand back and limit changes to the contract, get rid of some of the headaches for GPs”.’

However, local GP leaders were less optimistic about the deal.

Dr Tracey Vell, honorary secretary of Manchester LMC, said: ‘There is needless bureaucracy in the named GP for all patients which highlights politicians’ ignorance of how GPs work. I would have liked more details on financial support for premises.

‘Pointless enhanced services are still missing the point about avoiding admissions and extending access. The main feeling is “meh” - which is probably better than feeling that it is a disaster.’

Readers' comments (43)

  • According to CQC the OOH HAVE EXCEEDED his expectations while 2% of practices are failing and several others can do better. Why would the government want to change that unless either of them or both of them is/are lying.

    Increasing access means loss of continuity,why have named GP when access is important?

    If this the best the GPC can come up with then we are doomed.

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  • The GPC has become such a ridiculous organisation that it's not even worth listening to the members congratulating themselves every year. How on earth can the GPC claim any sort of victory for not lumbering us with OOH responsibility beyond 8:00 -6:30? Most of us work well beyond these hours as its stands and many are at serious risk of burn-out.

    I frankly couldn't care less what the GPC negotiates now. If the Government had imposed OOH responsibility or further extension of hours I would have resigned the next day (aged 41). I think I'd rather take my chances as locum than drive myself to an early grave.

    What the GPC seems incapable of understanding is that we should have the upper hand in negotiations with a workforce in crisis and an general election now due.

    As others have said we effectively have no union... it is sadly every man and woman for themselves.

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  • It's a bit worrying that the GPC consider these negotiations tough when market forces are so far in GPs favour.

    GPs should be dictating terms to the government not the other way round. It's something of a mystery that the BMA haven't pulled the plug on current NHS arrangements when practices are threatened with closure and the very existence of general practice is threatened by a recruitment crisis. We should be talking about patients needs not access.

    The GPC should be talking to the government about alternative models involving private GPs and co-payments like the rest of the western world. Instead we have got more bureaucracy whilst revalidation and CQC hammer nails into the primary care coffin.

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  • Behave yourself Chaand, how about telling the government what we want and threatening a ballot regarding mass resignation before the next election??? Grow a pair.....ex-partner now in oz......

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  • Revealed: How government narrowly avoided GPs going private in new GP contract

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  • I think the sniping is un helpful. if people feel they can take on being a leader - do so. In most industries it is a rare ability - but not always a quality!

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  • Vinci Ho

    (1) Chaand, I must admit that I probably have a 'soft' spot for you guys all this time. But quite frankly , the named GP and admission avoidance are just nonsenses, full stop.
    (2) As I said in the past , would not like your job but also it is at critical time like this people are having a lot of expectations on our negotiators.
    (3) quotes from Game of Thrones:

    Do you know what leadership means, Lord Snow?
    It means that the person in charge gets second-guessed by every clever little tw*t with a mouth.
    But if he starts second-guessing himself , that is the end, for him, for the clever little tw*ts , for everyone.
    This is not the end, not for us, not if you lot do your duty for however long to beat them back....
    Ser Allister
    GOT S4 ep9

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  • What a joke!

    ' I asked them to open their eyes and look at the facts in front of them. We have a situation where the Government’s own commissioned studies are talking about a workforce crisis. We have seen a 15% drop in young graduates choosing general practice as a career. We are seeing practices closing, younger doctors emigrating, leaving'

    That's the point you should have said, F-YOU government, this is the changes that we GPs want - more funding, less media-bashing, less QOF, CQC, a million and one other things..... not just timidly say, we'll just take what its been before. Its the current contract, amongst other things, that's responsible for the situation that we're in. and yes I have a right to snipe, if I was offered his job, I would work on behalf of my fellow GPs and with a greater passion and temerity.

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  • GPC has become a joke

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  • why don't have we a militant leader rather than a softie?

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