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At the heart of general practice since 1960

New GP contract does not let the Government off the hook

Dr Krishna Kasaraneni

The GP contract deal arrives at a difficult time for the NHS, with the Government’s decision to impose the junior doctor contract threatening to force a generation of young doctors abroad and wider pressures, from funding to rising patient demand, buffeting an increasingly stretched health service. Will this deal make a difference to creaking GP services suffering from its own huge problems? Sadly, while there are positive elements within this agreement secured by GPC in a difficult climate, we still need a much bigger, bolder rescue package for general practice that addresses the multitude of pressures that are pushing the profession to breaking point.

Stop the false promises and undeliverable election pledges and deliver a proper rescue plan that saves general practice 

Although the challenges facing GP services are well known, it is worth restating them from the outset. We have a service that is being overwhelmed by rising demand for appointments and other services from an increasingly complex population with divergent needs. Politicians of all parties have systematically failed to provide the funding to match this demand and to make matters worse have ignored the impact this has had on the workforce. A third of GPs told a BMA survey recently they were considered retiring in the next five years while in 2015 there were 600 trainee vacancies across England. The imposition of the junior doctor contract, which will make working in the NHS unattractive to all medical graduates, is unlikely to make this situation better. Added to this are delays with the investment in infrastructure funding, the running down of the GP occupational health service – I could go on and on.

In this environment, there are points in the new deal that will provide some positive news for GPs. There will be no extra workload related to the QOF which will at least means the pile of paperwork in front of GPs won’t grow any bigger – well, at least from the QOF – this year. We also have an agreement to explore the end of the QOF in its totality and the unpopular avoiding unplanned admissions enhanced service will also be reviewed. Both of these are positive developments as is a decision to end the dementia enhanced service, with all its resource going into core funding, and the agreement to increase by 28% the vaccination and immunisation item of service fee. Most strikingly, the GPC has agreed an uplift in GP practice expense funding to £220 million to cover rising CQC fees and rising expenses. I will spare readers a rant at the fact that the CQC fees shouldn’t be even in the air given the failing and calamitous nature of the current inspection regime, but at least this uplift will lessen the financial load on practices.

However, while these changes are ones that will help general practice, the Government should not be fooled into thinking it lets them off the hook. We still need a bigger plan on workforce, funding and managing patient demand if we are to not just to hold back the tide facing general practice, but crucially begin to turn the corner back towards the kind of innovative GP services all want to see.

My message to the Government therefore is clear. Stop the false promises and undeliverable election pledges and get down to the business of delivering a proper rescue plan that saves general practice from the calamitous situation it currently faces.

Dr Krishna Kasaraneni is chair of the GPC’s education, training and workforce subcommittee and a GP in Doncaster

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Readers' comments (7)

  • Well said.
    Pushing secondary care things to Primary care is good. But funds should follow. Unable to maintain experienced staff to provide better care as no fund in our pots. Staff prefer to work at tescos or else for the same money and less pressure from patients and work load. Cant cut down funding and increase expectation of patients. A 5 year old child can understand this. I was so passionate about my profession . not anymore.Now losing the passion as I could not satisfy my staff , my patients and my family.

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  • Krish. A giant raspberry should have been the GPC response to this supposed negotiation. Do not allow them to sell their crumbs to the public as a mutually agreed loaf. When are you lot going to dig in and fight? Elsewhere on these forums Paul Cundy asks whether the naysayers would rather the GPC had declined the 1%. And the answer, resoundingly, is yes. Walk away and let them persuade us back to the table when they have something to say worth listening to.

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  • Healthcare called the NHS in this country is merely a politicial game that politicial party (today he is Mr Hunt, and we know his ideology) in power will spin and manipulate to it own personal political gains. Remember the tory manifesto in last election. The workforce at the coalface do not have a say. I am sorry you, me or any shop floor worker has no say.We are forced to take it or leave it!!!! Yes poor juniors -the profession's future.

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  • My take home pay has gone down every year for the last five years, and is now much less than it was 10 years ago. That's despite working longer and harder. I don't suppose this year will be any different. I hear the cheers in advance of the demise of QOF, but working in a practice with a high burden of chronic disease and in a retirement town any regression to global sum and capitation rather than prevalence is going to mean an even bigger pay cut for us. Getting rid of appraisal would give me a week of my life back every year. Crown indemnity would give me two months of my take home back every year. That's what I want the GPC to negotiate on, not poxy pennies on flu jabs.

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  • its sad when negotiation becomes a damage limiting exercise.

    Now the Tories have a 5 year mandate to bulldoze any changes they want without opposition this is just the beginning of what's awaiting.

    Are there any realistic alternatives to RLE??

    I'd really like to hear the views of GPs who intend to stay and fight in the uk.

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  • Working as a locum at the moment, aged 51, waiting to see if GP Partnership or other longterm role interests me to jump back in..no way in H*ll with this kind of trivial vacillation. Please understand that the DoH doesn't want GMS in any form and has to walk the line of looking like it is helping, so that when we walk away it can be our fault in the eyes of the Media. Look at how they did this with NHS Dentistry. Message to BMA: please spend your efforts on positioning us well with the (Inter)National Corporates which is where we will end up. Yes, without this, we will all be in £50k pa 8-session contract drudgery for ever. GET ON WITH IT BMA! No more deckchairs, man the lifeboats. Please send a message to the SS Carpathia that we are coming, but at a premium. The Gong-seekers at the BMA know this already.. yes you do!

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  • This 'rescue package' is a pure fantasy. Why can't you accept it will never happen?

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