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DH threatens to impose contract changes after talks with GPC break down

Exclusive The Department of Health has broken off negotiations with the BMA and offered a make or break deal over GP practice funding, including a raft of new QOF work and 1.5% uplift to the GMS contract.

BMA negotiators said they had almost reached agreement on a new contract deal for 2013/14 with NHS Employers, but that the DH had ‘pulled the rug out’ from beneath the deal and demanded practices take on additional work.

In an ultimatum publically announced today, DH said it had begun a ‘formal consultation’ on the proposals and that if the BMA did not agree to the new deal they would impose it unilaterally.

The DH is offering GP practices a 1.5% gross uplift to the GMS contract, which it estimates would translate to an average pay increase of up to 1%.

But it comes with conditions attached that practices accept more work under QOF, with a more than a quarter of of the framework retired and replaced by new indicators and a gradual raising of upper thresholds over two years.

The changes would mean introducing a raft of new indicators into QOF including a revamp of the checks made in patients with depression, new blood pressure targets in the over 80s and new indicators for patients with rheumatoid arthritis and cancer.

The DH also announced proposals for nearly £19,000 of QOF income to be reallocated to new enhanced services encouraging better dementia diagnosis and care, and an expansion in online access to GP services.

Ministers also signalled some seismic changes to practice funding over the next few years, with the removal of the MPIG and correction of ‘anomolies’ in QOF funding.

The public announcement from the DH comes as negotiations between DH and GPC have broken down after months of talks, with the Government saying it ‘felt negotiations were not going anywhere.’

It also follows the DH rejecting the BMA’s plea for a change in the pay uplift formula to allow for rising practice expenses.

Related links

DH proposes over a quarter of QOF is retired

MPIG to be phased out within seven years in sweeping overhaul of GP funding

In full: BMA response to contract offer

GPs set for new indicators on depression and rheumatoid arthritis

QP indicators extended for a further year

QOF funding allocated to boosting online GP services

Health secretary Jeremy Hunt said: ‘Putting patients first is our priority and I make no apology for this. The GP contract needs to change so that it further improves care for patients.

‘We want the BMA to work with us on making this happen, but will not back away from making changes that will deliver better care for patients.’

A DH spokesperson said: ‘We think this is a good offer. Our message to the BMA is to think long and hard about it.

The door is open to come back to negotiations. At the end of the day, the final decisions lies with the Government but we want to work with them for something that suits both parties.’

He added: ‘We don’t think practices should be rewarded for good organisation but for good clinical care, like reducing mortality rates and improving patients’ lives.’

GPC chair Dr Laurence Buckman told Pulse: ‘We have been negotiating for five months and had agreed on a number of things but the DH is now pushing ahead with points that we had already rejected in negotiations, either because they were unworkable, increased workload or were not safe for patients.

‘Two weeks ago we thought we were close to a deal. We had negotiated over a range of issues but the Government has now pulled the rug out and said “we want this”.

‘The Government has told us we either agree to it or they will impose it.’

Readers' comments (23)

  • The Gordon Brown style of negotiation lives. Take this or I will impose worse

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  • I think on the face of it this seems a reasonable offer. HOWEVER what it ignores is the fact that certainly where I work the coalface is at breaking point and the only way to take on more work is to take on more staff; hence any apparent uplift in our pay will be more than swallowed up by these extra costs; when will the Government (of any colour) actually invest in the coalface thats what I want to know; I can't afford yet another paycut but what I REALLY want is to be able to take on more staff so I can do my job properly but I don't see why I should personally pay for that whilst we still have an NHS; Memo to Government: stop wasting money on overmanaging us or offering sweeteners to private companies and invest in coalface clinical staff PLEASE

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  • Vinci Ho

    Predictable
    You can see that coming anyway
    Make it very hard to acheive in QOF will balance out the 1.5% uplift . Government still wins........

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  • I don't feel that money is the biggest issue here. I cannot take on ANY more work .......even with the tiny uplift being proposed. There is no time to get used to the changes in the QOF indicators each year before they are changed again. Some of the points currently available for the organisational indicators will almost certainly simply "disappear" in the same way others have done in the past. Hence the overall result will be as it always is......more work and less money. I am counting down to retirement, and if I reach breaking point sooner I will be leaving General Practice before it permanently damages my health.

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  • I think we should form a union.

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  • i will kindly donate the 1.5% pay rise,to top up the the pay rise of the politicians if they accept the offer.i still have another 5 years of valuable experience and services i can give the community,but the politicians are making it unworkable.retirement here we come

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  • I also think we should form a union

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  • So how does this cover rising expenses????????????????????????????

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  • Nothing surprises me these days with the ConDems. Robbing the poor to pay the rich and all that. Historically GPs have always done worse under right wing governments compared to socialist ones - its a cultural thing "know your place my good man" we need to get back to the "good old days" were GPs get little pay and attract failed hospital Drs. Doubt there will be many GPs benefiting from the drop in higher rate tax with this "pay rise" - you've got to laugh havenn't you - and they want CCGs to work - who are they kidding - in 5-6 years time we'll look back and say - obvious wasn't it - GPs were mugs to take the wrap for the demise of NHS and the expansion of American private insurance companies into running health care for working middle clases and wealthy in UK - bit of "Dave'll fix it" - we all knew about what he and his chum Andy glitter were up to but we didn't say anything

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  • This is the best way to destroy any remaining good will. Between a QOF that often interferes with decent consultations and a QP that requires random reports, (our commissioning support are currently judging ours to see if they are 'uniform' enough - I haven't had any homework sent back since a piece of Latin translation in the Upper 4th - hope this isn't the first) along with CQC and a new set of practice 'protocols' some of us just about find the energy to deliver some decent medicine. Roll on retirement, not that long now...

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