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Call for separate GP contract to ‘reflect Scottish priorities’

There is ‘little sense’ in a UK-wide GP contract and Scottish practices should have a separate deal negotiated from their colleagues south of the border, says an influential think tank.

In proposals that go much further than the ‘tartanisation’ proposed by the Scottish government, Reform Scotland said the current contract ‘largely reflected circumstances elsewhere’ and should be rewritten for Scottish GPs.

The proposals provoked a furious response from the Scottish GPC, who said there was already enough flexibility in the GMS contract for Scottish GPs.

It comes after Pulse revealed last month that the Scottish Government is looking into setting out some Scottish-specific QOF indicators as part of the work to make more of the Scottish GP contract specific to the country, whilst not entirely stepping out of the UK deal.

The Reform Scotland report said the English and Scottish health system were ‘increasingly diverging’ due to changes set in place under the Health and Social Care Act.

The report concludes: ‘Reform Scotland believes that it makes little sense for Scotland to remain part of the UK GMS contract. Instead, we believe that a separate deal should be negotiated for Scotland.’

‘This doesn’t mean that the deal agreed would necessarily be all that different and there would be nothing stopping those involved in the Scottish negotiations from simply mirroring the English deal. 

‘But importantly the final agreement for Scottish GPs would be made for Scotland reflecting Scottish circumstances and policies, rather than tagged on to a deal which largely reflected circumstances elsewhere. ‘

It also recommends GP practice catchment areas are extended to allow greater patient choice and deregulation to allow GP practices practices to be run by private companies.

Scottish GPC chair Dr Alan McDevitt said that while it was ‘appropriate to discuss’ more Scottish flexibility to the contract, the UK contract is flexible enough to accommodate these differences.

He said: ‘There is already significant variation within the UK contract.  The Global Sum has always been divided amongst Scottish practices via a Scottish Allocation Formula, which was negotiated separately to reflect Scotland’s unique geographical and population differences. 

‘Most enhanced services are negotiated and agreed separately in Scotland and reflect Scottish priorities and there is no point reinventing the evidence base for clinical indicators in the quality framework which are the same for every GP and patient wherever they live and work in the UK.’

 ‘I would prefer that debate centred on how we can meet the challenges ahead without losing what is so good about Scottish NHS General Practice.’

Meanwhile, the Scottish Government said it is in negotiations with the SGPC and the Scottish NHS Boards to develop the ‘more Scottish-focused’ GP contract but will not fully renegotiate the contract at this time.

A Government spokesperson said: ‘Whilst now is not the time for a full renegotiation of the GP contract the time is right for greater focus on Scottish priorities. Development of a more Scottish focused GP contract is just one strand of our work to ensure that general practice can play its full part in meeting the needs of Scottish patients in the years to come.’