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Welsh GPs want greater powers to decide on health budgets

Welsh GP networks should be handed decision-making powers and delegated budgets, GPC Wales has said.

The recommendation has come as part of a document outlining the GPC’s vision for the future of general practice in Wales, alongside calls for the GMS contract to amount to 10.3% of the country’s overall NHS budget.

The GPC has also said Welsh politicians should be realistic about what can be delivered with the resources provided and focus rapid access policies only on those with urgent clinical needs.

According to the GPC, the GP ‘clusters’ agreed as part of the current financial year’s Welsh GP contract present ‘real potential’ for ‘reshaping care’.

The report said: ‘GP cluster networking has been built into the GMS contract for 2014/15 as a foundation on which to build. In the longer term, GP cluster networks could manage community staff, take on delegated budgets and drive service delivery to patients. With increasing autonomy there is real potential to work closely with Community Health Councils, social services and other parties to provide more integrated services closer to home.

‘Reshaping care will require close collaboration and joint decision making with hospital consultants as key contributors to the networks. The potential for better coordinated and streamlined patient care is dependent on LHBs allowing resources to be devolved and refocused on clinical advice generated through collaborative GP cluster networks.’

GPC Wales chair Dr Charlotte Jones said that unless ‘significant challenges’ facing GPs are addressed it will ‘lead to a perfect storm of an unsustainable service and potentially the collapse of Welsh general practice’.

She added: ‘GPs and their staff across Wales are reporting rising stress levels relating to unrelenting increases in workload (patient numbers and complexity of sickness) together with an escalating recruitment and retention crisis. All this comes on a background of significantly declining resources. GPC Wales wants to engage constructively with Welsh Government, health board executives and other key stakeholders and has offered a variety of solutions on a number of issues all of which are carefully considered in this document.

‘We believe that if the areas of concern are addressed effectively, it will ensure that high quality general practice is maintained. It is our goal that patients continue to have access to a high quality service which is responsive to patient needs and provided equitably across Wales.’

The BMA published a wider general practice policy document last year calling for more funding and for GPs should work together in networks offering extended access.