The Welsh GPC has rejected the final offer on the GP contract for 2013/14 from the Welsh Government, despite being offered a further round of concessions on the additional QOF workload likely to be imposed on practices in England.
The rejection means that the Welsh Government’s final proposals will now form the basis of a consultation and it will impose those terms on GP practices from 1 April 2013.
The rejection comes despite reaching a number of concessions with the Welsh Government, which means the final Welsh contract looks likely to fall somewhere in-between the English contract imposition and the negotiated deal for Scotland.
GPC Wales had rejected a previous contract deal from the Welsh Government modelled on the deal announced by the Department of Health in England in October, but ministers came back with a revised offer in December.
GPC Wales admitted the deal was ‘far less damaging to practices than those in England’, but that it marked a huge increase in workload for Welsh GPs and that it could not support the withdrawal of the MPIG.
The deal will retain 59 points from the organisational domain of QOF and will lessen the impact of hiking QOF thresholds by tying the upper thresholds to median performance – rather than the upper quartile, as in England.
The deal will not implement some new indicators branded ‘unworkable’ by the GPC, such as those with raised thresholds for hypertension indicators and a new indicator for annual exercise checks in hypertensive patients.
There will also be no reduction in the QOF indicator time limits from 15 to 12 months.
As in England 17 points related to blood pressure screening will be transferred into the public health domain. The other points will be used to fund the new QOF indicators and a new risk profiling indicators for the ‘quality and productivity’ domain.
Further, the Welsh Government has recommended a pay uplift of 1.5%, although it said it would be ‘mindful’ of DDRB uplift recommendations, should these exceed 1.5%.
The Welsh Government said it intends to eliminate MPIG over seven years from 2014/15 – as in England – but it will ensure there are ‘robust measures’ by health boards to ‘to ensure viability of the practices’ affected.
Welsh GPC chair Dr David Bailey said concern over the changes to correction factor was the reason why the GPC had rejected the deal.
He said: ‘GPC Wales could not agree to a negotiated settlement that included erosion of the correction factor even though we accept that this would not reduce overall GMS funding
‘The proposed changes to the contract in Wales represent a very significant increase in workload for, for the majority of practices with a correction factor, no increase in pay. In addition the protection of correction factor which the Minister of Health in 2004 said would be “in perpetuity” will be lost by 2021 for the over 60% of Welsh practices who still receive it.’
‘Whilst it would be unfair not to recognise that these changes will be far less damaging to practices than those in England, they, along with increased pension contributions, are likely to lead to the largest drop in income for Welsh GPs since the dawn of the new contract.’