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Welsh GPs secure negotiated contract deal protecting the income guarantee

GPC Wales has secured a negotiated contract deal for 2013/14, protecting Welsh GPs from plans to scrap the income guarantee.

The deal reached is based on the contract proposals in England but with a number of significant concessions negotiated by GPC Wales, most notably throwing out plans for removing the MPIG over seven years.

Welsh GPC chair Dr David Bailey warned that the plans to remove MPIG would lead to some rural Welsh practices having to close, a move which led to talks being resumed two weeks ago.

The Welsh GPC has agreed to ‘discuss more equitable funding’ to see if anything needs to change for future years, but for now the MPIG will be protected. This follows a similar agreement in Scotland, where the GPC reached a negotiated contract deal in December.

Furthermore, the GPC said it has secured a promise consideration will be given to financial issues that are beyond the control of practices, such as rurality, unavoidable smallness and multi-site practices in future agreements. There is also a recognition that extreme outliers may need to have a nationally negotiated off-formulary solution.

Dr Bailey said: ‘We have agreed to the Welsh deal unanimously at Welsh GPC. We are satisfied that this represents the best achievable agreement and that it is pretty close in workload terms to where we were last October in national negotiations, although the threshold situation is less favourable. It is unquestionably much less damaging than the English imposition and now no longer carries the threat of destabilising a significant number of practices.’

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The deal also includes a number of concessions with regards to increased workload, which is the key sticking point preventing the UK GPC from returning to negotiations with the Department of Health over a deal in England.

As previously reported by Pulse, the Welsh Government has agreed to retain 59 of the 154.4 points from the organisational QOF. It will also 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 removes 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 remaining organisational points that are being scrapped 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 recommendations should they exceed 1.5%.

Dr David Church, a GP in Machynlleth, Wales, commented: ‘The new offer even as negotiated by the BMA supposedly on our behalf is intended to cut our overall practice income substantially, even if we keep MPIG - but that may be at risk again next year anyway. By the time we have paid essential increases in costs, additional expenses of satisfying revalidation, CQC and employee salaries, in actual terms this represents a significant reduction in GP pay.’

‘It is not a deal made by or on behalf of GPs, who clearly told the GPC to take a much firmer stand.’

The deal leaves Northern Ireland as the last remaining devolved nation to reach a deal on the 2013/14 contract. GPC describes the situation as ‘fluid’, with talks still ongoing but the Northern Irish Government has said it expects to produce a consultation document before the end of the month if no negotiated deal is reached.

It comes as earlier this week, the GPC urged the UK Government to stop ‘discriminating’ against English GPs and offer as good a deal as in Scotland.