Exclusive: The GPC will reject ministers’ proposals for sweeping reforms to the GP contract and instead wait for an independent assessment of GP pay – even though the Government has warned it may impose a worse deal as a result.
The Department of Health has offered a 1.5% funding uplift if GPs agree to an unprecedented series of changes to the contract, including a raft of new QOF work next year and from April 2014 the phasing out of the MPIG and a rewrite of the Carr-Hill formula.
Although ministers said the proposed changes were not ‘set in stone’, the DH is pressing ahead with preparations to impose a deal and warned waiting for the Review Body on Doctors’ and Dentists’ Remuneration’s report in February could land GPs with a smaller funding uplift than is currently on the table.
The DH will begin a formal consultation on its plans this month, after which it can impose them without further negotiation.
The GPC has been tight-lipped on how it will respond, and is assessing the full impact of the changes. But its chair Dr Laurence Buckman told Pulse the additional workload involved was ‘unsustainable’.
‘We would have to agree to absolutely everything [to get the 1.5% uplift] and we said we will go to the DDRB, as we were going to anyway,’ he said. ‘We will continue to talk to the Government, to the profession and we will take any steps necessary to preserve general practice in the UK.’
GPC negotiator Dr Chaand Nagpaul added: ‘We are in an impasse at the moment. Ultimately the Government has got powers to make unilateral changes – but that doesn’t make it a wise thing to do.’
He added: ‘We are not negotiating with the Government on those proposals.’
The proposed deal would hit practices with 22 new QOF indicators, raise QOF thresholds and shift around £19,000 from the organisational QOF domain into new DESs covering dementia, online access and chronic long-term conditions.
It also includes a commitment to move towards more ‘equitable’ practice funding by abolishing MPIG over seven years from 2014 and revamping the Carr-Hill formula to favour practices in deprived areas.
Dr Asad Mubarik, a GP in Oldham, said there was ‘a feeling of anger among grassroots GPs’.
‘Loss of the MPIG will destabilise many practices,’ he said. ‘The proposed QOF changes do not follow good clinical care but are simply a cost-cutting exercise. We are relying on the BMA to fight our corner but after past conflicts such as pensions I have little faith.’
A DH spokesperson told Pulse the DDRB would be asked to make a recommendation if the GPC did not agree to the deal.
She added: ‘[The DDRB] could actually come out and recommend less than a 1.5% uplift, so that is a risk they could take.’