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Wales ‘should follow Scotland’ on new GP contract

Wales should be seeking to emulate much of the new Scottish contract when drawing up its own plans for general practice, an assistant medical director for NHS Wales has suggested.

The GMS contract in Wales is currently undergoing a ‘fundamental review’ with NHS Wales, Welsh Government and BMA representatives.

Dr Sally Lewis, who is also a GP, tweeted: ‘The proposed new Scottish GP contract is inspired, bold and exactly the way we should be heading in my opinion.’

She added that GPs need to accept the model ‘has to evolve for sustainability’ and singled out reduced risk for independent contractors, long-term premises plans, and a focus on the GP as an expert medical generalist.

Welsh negotiations have only just begun with working groups set up to develop new contract proposals based on workforce, minimising risks, cluster development, funding, demonstrating quality and integration.

Dr Charlotte Jones, Welsh GPC chair said there was quite a lot in the Scottish contract that was similar to what was already being planned or had happened in Wales but that ‘the pace of change is different’.

She said Wales had already committed to the independent contractor model and were evaluating several different ways of working around issues such as multidisciplinary teams for which it would probably not be a ‘one size fits all approach’.

Dr Jones added: ‘There are elements [of the Scottish contract] we absolutely love. ‘Those would be around premises, that’s really positive because that’s one of the biggest barriers to new entrants to partnership.

‘I also really like the shared data control and we really like the protected professional time for GPs.’

She added they were pleased to see that practices had been guaranteed no loss of income even though services such as vaccination were being removed from the contract.

‘There is some really good stuff in there and it is really good to see this in black and white.’

Dr Jones said it was inevitable that although the core offering would be relatively consistent, the four nations of the UK would take very different approaches.

The Welsh GMS agreement for 2017/18 included a 2.7% uplift, some new national enhanced services and a continued freeze on parts of the QOF.

In Northern Ireland there are also plans to bring in a wider healthcare team to support general practice but political stalemate has left GPs in a very different position to their counterparts in Scotland.

‘What has happened in Scotland is hugely significant in terms of funding streams.

‘If we were to get an equivalent cut, it would be worth £120m – that would be the same sort of investment’, NI GPC chair Dr Tom Black said.

He added: ‘If we got that we could do the pharmacist, mental health workers, care navigators and build up IT, just like in Scotland.’

But he said GPs in Northern Ireland would be unlikely to vote for a contract like that on offer in Scotland because they would not want to give up any independence.

‘If you have trust you can reach the agreements they have in Scotland.

‘We need to be more careful and probably are more wedded to the independent contractor model until we see where things are politically.’