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We need a transition to QOF changes

It is intrinsically fair that practices move to remuneration proportionate to their workload and quality of care delivered.

The difficulty is that business planning must be based on cash flow and there has not been a previous 'fair' basis to income under old GMS or newer contracts so any change affects cash flow.

Practices should be lobbying their LMC to calculate the changes and engage with the PCT to produce transitional relief arrangements. This really will be the test of the political intentions.

Those areas that do not arrange relief clearly wish to relegate GPs to salaried employees - either of the PCT provider arm or some APMS corporation.

Dr Andrew Mimnagh, Sefton LMC

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