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BMA analysis of ‘damaging’ contract changes rebuffed by ministers



The BMA has fought back against the Government’s imposition of its proposed changes to the GP contract in England with a 30-page analysis detailing how they will hit practices and patients, but its call for a rethink has been rejected by the Department of Health.

The official response to the consultation contains the results of a survey of 8,000 GPs, and found nearly 90% of GPs in England say they will be less able to provide good quality care as a result of the Government’s proposed contract deal for 2013/14. Click here to read the full survey results

It also showed nearly two-thirds of practices in England are planning to make changes to current services available to patients. Of those, over half (54%) said their practice would have to reduce access to patients.

It also argued key aspects of the contract proposal should be delayed, including the plan to give practices the job of paying locum superannuation and the reduction in the time-frame for QOF indicators from 15 to 12 months.

It also says the proposed changes ‘work against the thrust’ of the Francis Inquiry’s recommendations by introducing increasingly challenging targets for ‘box ticking rather than core holistic patient care’. It also claims that the proposals will place an ‘enormous strain’ on practices and reduce the chance of adequate engagement and input from GPs into CCGs

But the Department of Health was quick to insist that the changes would focus time and money onto patient care and ‘have the potential to save more lives’.

The BMA survey found, of the GPs saying they would have to make changes, nine out of ten (91%) said they would not be able to see patients for routine appointments as quickly as they currently do, while three-quarters (75%) expected to reduce the range of services offered to patients.

GPC chair Dr Laurence Buckman said the BMA was happy to discuss options for new services, but that this huge package of changes was ‘simply not feasible in practice’ .

He said: ‘The changes would make it difficult for practices to maintain the level of care they currently offer while introducing an even greater focus on targets and box ticking at the expense of holistic, patient-centred primary care.

‘The Government needs to address the serious concerns expressed by GPs. If they fail to make changes to their proposals they run the risk of damaging patient care and undermining the very services they are seeking to improve.’

Contract negotiations between the NHS Employers and the GPC broke down in October, when the Government threatened to impose wide-ranging changes to the GP contract in return for a 1.5% uplift to GP funding.

Health minister Lord Howe responded, saying the contract changes would mean ‘better care for all’.

‘Our proposals are not about imposing new targets. They are designed to reduce the amount of administrative box ticking and to focus time and money more onto direct patient care. They would ensure more patients get access to high quality clinical care and have the potential to save more lives.’

It comes as the GPC in Scotland and Wales have agreed separate contract deals for 2013/14, with both securing promises to retain correction factor payments and achieving concessions on QOF changes.

A spokesperson the NHS Employers said: ‘After the GP contract consultation ends on 26 February ministers will take into account the representations that have been made during the consultation and then decide how to proceed.

“We have consistently and publically stated that the package of proposals on which the Department of Health are now consulting is consistent with where NHS Employers tried to take negotiations with the GPC last year. In those negotiations we sought to reach agreement on changes that significantly improve patient care and in particular, get more practices to deliver what the better practices already achieve.”