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Ministers consult with GPs on ‘Scottish-focused’ contract

Exclusive: GPs in Scotland are being consulted on a Scottish version of the GMS contract and could be working to a series of Scottish-only QOF indicators by April 2014, Pulse can reveal.

Pulse has learnt the Scottish government is holding a series of talks with GPs, LMCs and NHS chief executives on how to implement changes towards a ‘Scottish-focused' contract.

Pulse understands the meetings will gather ideas for a localised contract, and are the precursor to a special ‘programme board' that will take forward their recommendations, and will include members from NHS Boards and the Scottish GPC (SGPC).

The Scottish government is also planning to introduce a raft of Scottish QOF indicators from April 2014, to start implementing a promise made in December last year to make three-quarters of the income from the GP contract locally determined.

It has tasked Health Improvement Scotland, which was set up last year, to prepare new QOF indicators that will form the basis of negotiations with the Scottish GPC for the first time. The new indicators are likely to be in areas such as alcohol, smoking, and improving patient safety and care in deprived areas.

A Scottish government spokesperson refused to give definite timescales for the changes, but said: ‘We are committed to developing the GP contract in Scotland.

‘We are currently in the process of establishing a Programme Board to provide strategic leadership and governance that will include membership from Scottish Government, SGPC and NHS Boards.'

The idea of a Scottish GP contract has been criticised as ‘ideological' by the GPC, but welcomed by some members of the Scottish GPC.

Dr Bob Mack, a GP in Dumfries and Galloway, a member of SGPC and deputy chairman of Scottish LMC conference, said flexibility was needed. 

He said: ‘The Scottish government health department has held a round of meetings with GPs for information gathering. As far as I am aware, the main area of suggested change will be in QOF.

He added: ‘We shouldn't have an entirely separate contract from the UK-wide contract because we still benefit from it, but we should have Scottish variation bringing us flexibility.'

Dr Georgina Brown, a GP in Glasgow and a member of SGPC, said: ‘I think suggesting that one contract for the whole of the UK would be sensitive to the needs of a diverse population is naive.

‘There is definite strength in unanimity in terms of negotiation, but there has to be local adaptation and local response to differing need.'

GPC negotiator Dr Chaand Nagpaul said the UK contract was of ‘immense value' and the GPC would fight to protect it.

He said: ‘While we recognise this statement by the Scottish government, we think this is the wrong way to approach it. There is no point in simply having an arbitrary approach to separating from the UK contract for ideological reasons.'

A spokesperson for the SGPC said they remained committed to a UK-wide contract, and that they had not yet been told of any firm proposals.

The move comes as Northern Ireland health minister Edwin Poots is also looking at negotiating a larger proportion of the contract locally.

A health department spokesperson said: ‘Minister Poots has been giving this position added consideration now given the more recent variation across the four countries within the GMS contract.'


Next steps for a Scottish GP contract

  • Health Improvement Scotland to develop Scotland-specific QOF indicators
  • Scottish government to negotiate with the SGPC on new QOF indicators for 2014/15 GP contract
  • The Scottish Government to form ‘programme board' with SGPC to take forward new Scottish-focused GMS contract