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DH threatens to impose contract changes after talks with GPC break down

Exclusive The Department of Health has broken off negotiations with the BMA and offered a make or break deal over GP practice funding, including a raft of new QOF work and 1.5% uplift to the GMS contract.

BMA negotiators said they had almost reached agreement on a new contract deal for 2013/14 with NHS Employers, but that the DH had ‘pulled the rug out’ from beneath the deal and demanded practices take on additional work.

In an ultimatum publically announced today, DH said it had begun a ‘formal consultation’ on the proposals and that if the BMA did not agree to the new deal they would impose it unilaterally.

The DH is offering GP practices a 1.5% gross uplift to the GMS contract, which it estimates would translate to an average pay increase of up to 1%.

But it comes with conditions attached that practices accept more work under QOF, with a more than a quarter of of the framework retired and replaced by new indicators and a gradual raising of upper thresholds over two years.

The changes would mean introducing a raft of new indicators into QOF including a revamp of the checks made in patients with depression, new blood pressure targets in the over 80s and new indicators for patients with rheumatoid arthritis and cancer.

The DH also announced proposals for nearly £19,000 of QOF income to be reallocated to new enhanced services encouraging better dementia diagnosis and care, and an expansion in online access to GP services.

Ministers also signalled some seismic changes to practice funding over the next few years, with the removal of the MPIG and correction of ‘anomolies’ in QOF funding.

The public announcement from the DH comes as negotiations between DH and GPC have broken down after months of talks, with the Government saying it ‘felt negotiations were not going anywhere.’

It also follows the DH rejecting the BMA’s plea for a change in the pay uplift formula to allow for rising practice expenses.

Related links

DH proposes over a quarter of QOF is retired

MPIG to be phased out within seven years in sweeping overhaul of GP funding

In full: BMA response to contract offer

GPs set for new indicators on depression and rheumatoid arthritis

QP indicators extended for a further year

QOF funding allocated to boosting online GP services

Health secretary Jeremy Hunt said: ‘Putting patients first is our priority and I make no apology for this. The GP contract needs to change so that it further improves care for patients.

‘We want the BMA to work with us on making this happen, but will not back away from making changes that will deliver better care for patients.’

A DH spokesperson said: ‘We think this is a good offer. Our message to the BMA is to think long and hard about it.

The door is open to come back to negotiations. At the end of the day, the final decisions lies with the Government but we want to work with them for something that suits both parties.’

He added: ‘We don’t think practices should be rewarded for good organisation but for good clinical care, like reducing mortality rates and improving patients’ lives.’

GPC chair Dr Laurence Buckman told Pulse: ‘We have been negotiating for five months and had agreed on a number of things but the DH is now pushing ahead with points that we had already rejected in negotiations, either because they were unworkable, increased workload or were not safe for patients.

‘Two weeks ago we thought we were close to a deal. We had negotiated over a range of issues but the Government has now pulled the rug out and said “we want this”.

‘The Government has told us we either agree to it or they will impose it.’