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Majority of GPs oppose taking on ‘named clinician’ responsibility

Exclusive Nearly three-quarters of GPs oppose the introduction of any change to their contract to introduce 24/7 responsibility for vulnerable patients as a ‘named clinician’, an exclusive Pulse survey reveals.

The profession has roundly rejected the proposal from the health secretary for GPs to be the person ‘where the buck stops’ for out-of-hospital care around the clock, with 71% against the plans, 10% in favour and 19% unsure.

Pulse revealed last month that the GPC and NHS England are moving towards a negotiated deal for next year’s contract which could see GPs taking on the named clinician responsibility in exchange for a cut in QOF workload.

But GPC chair Dr Chaand Nagpaul told Pulse that he understood GP concerns about workload, and that they would not agree any change in hours of availability ‘beyond current contractual levels’.

With contract negotiations expected to conclude shortly, the survey of nearly 700 GPs also reveals that there are mixed views on Jeremy Hunt’s menu of proposed reforms to the GP contract:

  • GPs are split on plans to widen online access for patients: 34% said would support this, 26% said they would oppose it while a further 34% were unsure.
  • GPs support some aspects of Jeremy Hunt’s plans: some 73% are in favour of reducing ‘tick-box’ medicine through shrinking the QOF, 86% are in favour of increasing number of GPs by 2,000 and 87% favour increasing the overall proportion of funding going into primary care.
  • Overall, 44% were opposed to the whole package of reforms, 9% supported them, but most (47%) were unsure

Although the GPC says that negotiations this year are proceeding well, the majority of GPs would support taking a tough line if ministers attempted a similar move to impose a new contract as they did last year. Some 62% of GPs said they would support industrial action if this happened, while 22% said they would not. A further 16% said they were unsure.

In a recent blog post, GPC chair Dr Chaand Nagpaul said that the profession could only deliver the ‘personalised care’ the Government wants for vulnerable adults and those with long-term conditions with more investment.

Speaking to Pulse Dr Nagpaul said the Government’s proposals would mean that GPs have the responsibility for co-ordinating care out-of-hospital, not providing it.

He said: ‘I can fully understand the concerns of GPs who are already overstretched and overworked. But I reassure them that in our contract discussions, we are not discussing any change in hours of availability. The GPC would not be part of negotiations on extending GPs’ availability beyond current contractual levels. We are absolutely not entertaining any such a change.

‘Our understanding is that what the Government means by a named GP in this context is a GP who co-ordinates the patient’s care - but is not responsible for delivering it. In many cases, vulnerable patients are cared for by multidisciplinary teams in any case. It’s more appropriate that a named GP be responsible for planning that care but not for its delivery.

‘Already in the risk-profiling DES there’s a named GP and many areas have care plans developed in which there are named GPs. It clearly would not be appropriate or feasible for GPs to be responsible for 24 hour care for these patients or responsible for the out-of-hours service or other service providers.’