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Separate Scottish deal on GP contract defers decision on MPIG and secures QOF concessions



Scottish GPs have reached a separate agreement with the Scottish Government on changes to the GP contract, which includes the deferring of any decision about the future of the MPIG and a raft of concessions on the QOF changes proposed for 2013/14.

GPC Scotland said the deal, negotiated before any agreement has been reached on the UK-wide contract, would safeguard Scottish GPs from taking on too much extra work without being compensated, unlike the changes the Department of Health in England has threatened to impose.

However, the GPC Scotland and the Scottish Government have agreed to wait for the recommendations of the Review Body on Doctors’ and Dentists’ Remuneration before agreeing to an uplift to core funding.

Full details of the Scottish deal have yet to be released, and are expected later today. However GPC Scotland told Pulse that 77 points of from the organisational QOF domain would be moved into core funding. Any decision on the phasing out of MPIG is to be deferred for the time being, and the deal rejects some NICE proposals for new QOF work, including questionnaires for exercise in hypertension patients.

The GPC Scotland has also secured concessions over the planned hike in QOF thresholds, which will not be raised to the same extent as is expected in the rest of the UK, and quality and productivity indicators related to reducing emergency admissions will be removed in return for GPs agreeing to do risk profiling for patients with complex health needs.

GPC Scotland chair Dr Alan McDevitt said: ‘We’re going to shift some of the funding and work from organisational into core funding, 77 points’ worth. There will be no organisational domain after this in Scotland after this. There will be a new one, public health, which will have a management domain. All of the other ones will be in public health as management points, and probably another one that we have not got a name for yet but it will be about patient safety.’

He added: ‘With the correction factor, we have agreed to examine what that means in Scotland and what we can do with that. We have agreed to look at that over the next 18 months. There will definitely not be any change to that at the moment in Scotland.’

‘We started to try and achieve an agreement – for example the move of the organisational points into core funding is a major step towards stability of practice funding and was one of the things we wanted to achieve in the UK. That is not on offer as part of the imposition. The QP area is something we’ve been working on – these things that were going to be imposed as extra work in England as opposed to being replaced by other work in Scotland.’

He said funding lost from the QOF organisational domain would be shifted into core funding.

‘The other thing is that the Scottish Government has made it quite clear that they are going to wait for the DDRB report and will respond to that in terms of an uplift. That is quite a big thing as well. We have not negotiated that because we are waiting for the DDRB.

‘They have said they will respond to the report with an uplift, so there will be an uplift. That’s what we asked for, because we definitely want to hear the DDRB recommendation.’

Asked whether the Scottish agreement could pave the way for a negotiated UK-wide agreement, Dr McDevitt said: ‘I’d like to think it would. Our Government has agreed that it wants to help stabilise and support general practice and that this was a worthwhile aim. You’d think they [UK] would look at some of the things we’ve done and see if they would be worth doing. You are not going to achieve moving the work towards managing the most high risk patients in the community, and avoiding unnecessary hospital admissions, unless it is the kind of package that does that.’

‘We were doing an agreement rather than negotiating an imposition.’

It comes as GPC deputy chairman Dr Richard Vautrey indicated via his Twitter account that he expected the Department of Health to publish long-awaited details of its planned imposition for the rest of the UK imminently.

He tweeted: ‘Expect @DHgovuk to follow Autumn statement and bury the very bad news of imposing GP contract changes very shortly.’