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GPs go forth

Majority of GPs oppose taking on 'named clinician' responsibility

Exclusive Nearly three-quarters of GPs oppose the introduction of any change to their contract to introduce 24/7 responsibility for vulnerable patients as a ‘named clinician’, an exclusive Pulse survey reveals.

The profession has roundly rejected the proposal from the health secretary for GPs to be the person ‘where the buck stops’ for out-of-hospital care around the clock, with 71% against the plans, 10% in favour and 19% unsure.

Pulse revealed last month that the GPC and NHS England are moving towards a negotiated deal for next year’s contract which could see GPs taking on the named clinician responsibility in exchange for a cut in QOF workload.

But GPC chair Dr Chaand Nagpaul told Pulse that he understood GP concerns about workload, and that they would not agree any change in hours of availability ‘beyond current contractual levels’.

With contract negotiations expected to conclude shortly, the survey of nearly 700 GPs also reveals that there are mixed views on Jeremy Hunt’s menu of proposed reforms to the GP contract:

  • GPs are split on plans to widen online access for patients: 34% said would support this, 26% said they would oppose it while a further 34% were unsure.
  • GPs support some aspects of Jeremy Hunt’s plans: some 73% are in favour of reducing ‘tick-box’ medicine through shrinking the QOF, 86% are in favour of increasing number of GPs by 2,000 and 87% favour increasing the overall proportion of funding going into primary care.
  • Overall, 44% were opposed to the whole package of reforms, 9% supported them, but most (47%) were unsure

Although the GPC says that negotiations this year are proceeding well, the majority of GPs would support taking a tough line if ministers attempted a similar move to impose a new contract as they did last year. Some 62% of GPs said they would support industrial action if this happened, while 22% said they would not. A further 16% said they were unsure.

In a recent blog post, GPC chair Dr Chaand Nagpaul said that the profession could only deliver the ‘personalised care’ the Government wants for vulnerable adults and those with long-term conditions with more investment.

Speaking to Pulse Dr Nagpaul said the Government’s proposals would mean that GPs have the responsibility for co-ordinating care out-of-hospital, not providing it.

He said: ‘I can fully understand the concerns of GPs who are already overstretched and overworked. But I reassure them that in our contract discussions, we are not discussing any change in hours of availability. The GPC would not be part of negotiations on extending GPs’ availability beyond current contractual levels. We are absolutely not entertaining any such a change.

‘Our understanding is that what the Government means by a named GP in this context is a GP who co-ordinates the patient’s care - but is not responsible for delivering it. In many cases, vulnerable patients are cared for by multidisciplinary teams in any case. It’s more appropriate that a named GP be responsible for planning that care but not for its delivery.

‘Already in the risk-profiling DES there’s a named GP and many areas have care plans developed in which there are named GPs. It clearly would not be appropriate or feasible for GPs to be responsible for 24 hour care for these patients or responsible for the out-of-hours service or other service providers.’



Readers' comments (23)

  • "87% favour increasing the overall proportion of funding going into primary care"

    Who in GP is against more funding going to primary care? Is 8-9% of the total budget really enough? Maybe 13% didn't understand the question....

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  • What happens if you work half time?

    Have 12 hour a day named responsibility?

    Who then takes over?

    I think we should be told!

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  • I think EU working time directives etc prevents anyone form having 24/7 responsibility
    you cannot have 24/7 responsibility unless you are working 24/7 and available 24/7.
    what happens when I am in spain for 1/52 and the patient comes to harm/ becomes unwell due to no fault of my own- am I responsible.
    Jeremy is off his rocker to even suggest this in this day and age
    I will be an extremely peed off BMA member if this is not opposed on grounds of risk to the health of GP

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  • Worringly RCGP and BMA are in agreement with Jeremy Hunt (see RCGP's 2020 vision and BMA's recent comments about this in pulse, including leaked information suggesting GPC is likely to accept this).

    I suspect this will be forced upon us. Question is - what will be it's impact to general practice? They will certainly have one less partner next year if this is in my contract.

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  • A name clinician should be immediately changed to blame clinician as I assure you this is what it really means ; someone to blame the second something goes wrong . I recently sent a patient to a specialist who prescribed her ciprofloxacin . she was not sure if she should take it after doing a google search ,so she asked for my advice , I refused to give it as i thought it would be inappropriate for me to do so , she cashed in the prescription issued by the consultant and took the tablet, she reacted and a complaint soon followed after .A name clinician will be an NHS England management dream and a nightmare for everyone else ..

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  • "24 hour blamed clinician"

    I like it!

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  • I do not think the European Working Time Directive applies to GP partners as we are classed as self-employed. Salaried doctors propbably have to comply - which will dump yet more work on a dwindling number of partners - suspect this is the government plan all along, to force us into salaried service. Just sit back and watch it implode.

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  • If I am in my sick bed, will it be my responsibility to telephone around, looking for a deputy? if Hunt enforces this on us, it will never work, and within 2 years it will have faded into obscurity.There is nothing more stupid than an idea which cannot possibly work, stock in trade for politicians perhaps, but G.P.s are of a more practical bent

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  • No matter what madness is proposed/imposed we have to accept it or walk away. The DOH is bullying, discriminatory and in charge. Our take home pay per consultation has halved from about £ 8.00 to £ 4.00 per consultation because a pay cut in real terms of 25% and an increase in consultations of 50%. Yet, we are powerless in the teeth of such aggression towards doctors.
    When and where is the point that GP land becomes so impossible that we have to leave ? In my personal opinion it is here already and we should resign from the NHS and resell our services back such as with legal aid.

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  • Bob Hodges

    If any if this comes to pass, I will protect the first £800 of my pre tax earning by resigning my RCGP and BMA memberships.

    I think we should put a fence around the M25 to keep this imbeciles inside it, and then take the phone off the hook.

    Sorry, we can't hear you!

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