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GPs buried under trusts' workload dump

Quality pay 'will split up partnerships'

A wave of partnership splits has been predicted to follow the new contract after negotiators admitted up to a third of GPs may snub the quality framework.

Dr Tony Snell, co-deputy chair of the NHS Confederation core negotiating team, told Pulse that around 70 per cent of GPs would implement aspects of the quality framework immediately.

But the remaining 30 per cent would adopt a wait-and-see approach or decide not to implement the framework at all.

LMCs and GP accountants replied that an increase in splits was inevitable if so many GPs ignored the framework because their decision would hit partners' income potential.

GPs who opt not to work towards the quality markers will damage their practice's ability to win the extra cash promised for achieving the highest levels of quality. Quality payments are expected to make up 30-50 per cent of GP income under the contract.

Paul Kendall, a GP accountant and partner at Dodd and Co, said there was 'absolutely likely' to be an increase in partnership splits.

'Basically you would be forcing your partner to take on a lower level of income. It could be a significant amount of money you are asking your partner to forgo.'

Dr Ian Dumbelton, chair of Cambridge LMC, said there would be 'belligerent' GPs who would not want to alter their working patterns. 'If a partner resisted it would probably end up in a partnership dispute and possibly split up the practice,' he added.

Dr Snell said the contract could not force all GPs in a practice to work towards the quality markers.

He added that the 'very substantial financial incentives' on offer could be a 'real

reason for conflict' if one partner refused to chase quality payments.

Dr Snell said: 'In contractual terms there's nothing that can be done.

'You can't make people do things ­ it would then become a partnership issue ­ but I hope good sense would


GPC negotiator Dr Laurence Buckman said partners who refused to take up the quality framework when their partners were keen would

be under 'very impressive' economic pressure.

'I would have thought most GPs, however demotivated, when offered a substantial amount of money would do it,' he added.

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