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Buckman: Practices won’t have time to take on DESs

Exclusive GPs are likely to take a pay cut rather than implement all the four directed enhanced services the Government is proposing from April, as the workload involved will be ‘very steep’, says GPC chair Dr Laurence Buckman.

Dr Buckman said there was ‘nothing wrong’ with the four DESs themselves, but the Department of Health would reduce patient access to GPs by forcing the additional work on GPs without any additional funding.

The impending GP contract imposition will offer four DESs - worth £3,600 each - to GPs in England to incentivise dementia case-finding, developing access to online GP services, telehealth and case-managing patients at risk of hospital admission.

The DESs are funded by the removal of organisational QOF points, and if practices decide not to take them on will result in them losing a sizable chunk of their funding at a time of rising practice expenses and a raft of new QOF work also set to be introduced from April.

The admission comes after accountants advised GPs to cut their drawings by up to 10% before the expected contract imposition.

Dr Buckman said: ‘The obvious unintended consequence [from pushing through the contract changes] is that people won’t do the DESs that the Government so desperately wants them to do. There is nothing wrong with them as individual DESs, if you look at them and their subject matter.

‘The unintended consequences are going to be reduced access. The DESs, some of them, they won’t fall flat, I am sure some people will do some of them somewhere, but I guess a lot of people will not take on all four DESs. I am not sure actually you could take on all four DESs. The workload of all four is very steep.’

Dr Buckman made the comments in an exclusive interview with Pulse, where he defended the GPC’s handling of the contract negotiations and admitted the DH ‘holds all the cards’.

He said: ‘You can’t block what governments decide to do. There are many things governments decide to do that I don’t agree with, or indeed that the vast majority of the population doesn’t agree with. But that doesn’t mean they don’t happen.’

‘Now what we have to do is make sure that GPs are as equipped as they can to cope with what is coming, that we can do our best to diminish the damage that the deal, as imposed, will put on doctors.’

He also said there was ‘no point’ in industrial action or any boycott of commissioning, even though a Pulse survey found 52% of the profession would support it.

He said: ‘Some of us suspect that the Government may not actually mind terribly much if GPs did not take part in commissioning, so we may be playing into their hand by saying: “Well then, we’ll stomp off the pitch.” Who would take over? It sure won’t be GPs.’ Watch the full interview here

The comments come as the BMA urged GPs to get involved by submitting their own responses to the Government’s proposed deal directly to the DH. It also launched a tool for GPs to calculate exactly how much funding they face losing from the proposed changes to the QOF.