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Winners get 3 times more than losers

Each GP will get as little as £57,000 or up to £154,000 as their global sum during the first year of the new contract, Pulse has learned.

A single point on the quality framework will be worth anything from £14.25 to £38.50 per GP.

The global sum will make up more than one-third of GPs' income, and quality pay is expected to account for a third.

The remainder will come from enhanced services.

The huge variation in resources for practices emerged as the Department of Health revealed the extremes generated by the Carr-Hill formula, which determines a practice's notional list size (see box).

Each actual patient will count for between 0.57 and 1.54 notional patients under the formula for calculating how much income GPs will get. An average GP with 1,800 notional patients will receive £100,000 through the global sum and earn £25 for each quality point.

Although there may be big winners and losers in the long run, the NHS Confederation pledged that a pay protection scheme would ensure every GP would see their income rise in the first two years of the contract.

Only a tiny fraction would be out of pocket in the third year, said lead negotiator Mike Farrar.

'They will be gaining in 2003/4 through the new

investment, the pay uplift and the money for the quality framework,' he said. 'In the second year we have given 100 per cent protection in transitional support so there can't be any losers.'

The guarantee came as GPs waited on tenterhooks for the BMA to tell them their

notional patient list size.

The BMA has worked out the figures for every practice and has pledged to mail them by the end of this week.

GPC negotiator Dr Laurence Buckman said the Carr-Hill formula was 'absolutely fundamental' to GPs. 'It's absolutely terrifying as well

unless you've got a PhD to understand it,' he said.

The notional list is calculated from:

 · The age and gender of your patient list

 · How many patients join and leave your practice

 · The average morbidity of your patients

 · How many patients are in nursing or

residential homes

 · How rural your practice is

 · The cost of employing practice staff in your area

'I can't decide until I'm told my earnings'

Dr Barbara Rushton says her vote hangs in the balance as she still can't tell what she will be earning under the contract.

'We haven't got a clue what we are going to earn,' said the GP in Liphook, Hampshire. 'It's all cutting it very fine. Until we have that information it's impossible to make any decisions.'

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