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Q&A: What next in the battle over the GP contract?



When and why did the contract negotiations break down?

At the end of October, the Government offered a make-or-break deal on the GP contract, claiming that the GPC had walked away from negotiations. However the GPC accused the Government of not being willing to negotiate but wanting to push through all of its proposals.

What is the Government doing now?

The Department of Health launched a 12-week consultation in early December on its proposed changes to the GP contract in England – a move which clears the way for an imposition from 1 April.

Whatdo the proposed contract changes involve?

In a 37-page letter, the DH set out in detail the raft of new QOF work that practices will be asked to take on, and outlined four new directed enhanced services that will be funded by a 10% reduction in the size of the QOF. The DH also announced vaccination programmes for rotavirus and shingles and preparations for the phasing-out of the MPIG over seven years from April 2014.

Full details and analysis of all the changes can be found on our dedicated GP contract page.

What about an uplift in pay?

The DH offered the profession an uplift of 1.5% in return for agreeing to all of its proposals for changes to terms. Upon launching the consultation, that offer was withdrawn and the Government is now waiting for the recommendation of the Doctors’ and Dentists’ Review Body (DDRB) on a pay uplift, after which it will make a decision.

When will the DDRB make its recommendation?

This is expected in mid-to-late February.

On what basis will it make the recommendations?

The DDRB uses a formula to calculate the uplift based on evidence submitted by stakeholders including the BMA, NHS Employers and the DH. The DH caused a stir by claiming in its submission that GPs are happier than ever and maintaining income levels.

The BMA has called for the DDRB’s formula to be revised, arguing that pay uplift recommendations in recent years have failed to keep pace with rising inflation and practice expenses.

So what is the GPC doing now?

The GPC has said it is not expecting to be able to block all contract changes but wants to minimise the damage. It is set to launch a survey of GPs this month asking for their views on the Government’s proposals. It intends to use the material to underpin its negotiating position with the Government. GPC negotiators will also tour the country appearing at a series of roadshows to meet with GPs locally in late January and early February.

What about strike action?

The GPC has ruled out strike action but not other industrial action, although at this late stage any type of industrial action looks increasingly unlikely. LMCs have hotly debated a possible boycott of commissioning, although GPC chair Dr Laurence Buckman has clearly stated he believes such a boycott ‘wouldn’t work’.