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Northern Ireland GPC to agree smaller cuts to the QOF in deal that signals ‘end to UK-wide contract’

Exclusive GPs in Northern Ireland are set to have around 240 QOF points removed from their contract next year and funding shifted into the global sum equivalent under a new deal struck by the Northern Ireland GPC, Pulse can reveal.

The Quality and Productivity indicators will remain in the QOF under an agreement reached today with Northern Ireland’s Health and Social Care Board - in sharp contrast to the English agreement, which has removed all points from the QP domain. The full contract deal, which is due to be finalised next week, is also expected to see a hike in some lower thresholds for QOF indicators.

The deal means the Northern Irish QOF will remain bigger than in the English deal, which saw the removal of 340 points.

GP leaders said the agreement signals the further break-up of of the UK-wide contract.

Northern Ireland GPC chair Dr Tom Black described the deal as a ‘score draw’, and added: ‘This is recognition that GPs in Northern Ireland are the highest performing across all four countries. We also have the lowest workforce and the lowest funding. There is a realisation that sheer workload is the problem for GPs and that something had to be done to reduce that.’

There were still a number of areas to be discussed, he added, including enhanced services, which will be negotiated separately by the Northern Irish GPC and the Health and Social Care Board.

The principal issue was around increasing funding to encourage more GPs to undertake out-of-hours work, he added.

Dr Black said: ‘The big issue now in Northern Ireland is out-of-hours. There’s difficulty getting GPs to do it. We now need to persuade the board to increase funding streams. They recognise that need. But the fact is we´ll need a considerable increase - around 70% to come up to the levels available in Wales for example.’

Dr Peter Swinyard, a GP in Swindon and chair of the Family Doctor Association said the deal meant the break up of the UK GP contract. He said: ‘Well of course it does. But it was inevitable. The writing has been on the wall for a long time. You can´t have four devolved nations for long without things going their separate ways.

‘Of course, I´d rather we had a national GP contract but with the four nations, you no longer really have one NHS but an EHS, an SHS, an NIHS and a WHS. In the long run it´s probably a good thing if the contracts are more locally focused but GPs who work in, say, Scotland might find it difficult if they come to work in England because things will be so different. But we can´t wish we were back in 2004. It isn´t going to happen.”

Pulse revealed back in September that the GP contract would this year be negotiated for the first time on a country-by-country basis, in a move heralding the apparent break-up of a UK-wide contract.

Last week negotiators in Scotland said talks north of the border were still ‘at an early stage’, although the Scottish Government and GPC Scotland have both agreed to pursue minimal changes to the contract for next year. The BMA said there was an ‘understanding’ that if both sides agreed the English changes would be beneficial, they may be introduced north of the border

In Wales, the Government and GPC Wales are agreed on cutting bureaucracy and ‘inappropriate’ workloads for GPs in a move towards returning to ‘the art of holistic general practice’, with the hope an agreement can be reached by Christmas.

A DHSSPS spokesperson said: ‘Negotiations are currently underway with Northern Irish GPC regarding a wide range of issues within the GMS contract including the make-up of the QOF. The Department will continue discussing the proposed changes to the contract with Northern Irish GPC in an effort to reach an acceptable agreement.’