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Another day, another contract

Another year, another 86-page contract update to plough through. That in itself would be enough for the change-fatigued to jack it all in. Let’s press on, though.

Pre-contract negotiations, it was hard, wasn’t it, to imagine what ‘victory’ might look like? Though, given the absurdity of the draft service specs, it was obvious we were anticipating some kind of win, as things could only get better. So is the trumpeting around the contract revision justified triumphalism, or a collective and protesting front-line fart? Well, let’s look at those headlines:

  • More roles added to the additional role reimbursement scheme! Now featuring, wait for it, care coordinators, health coaches, dietitians, podiatrists, occupational therapists and pharmacy technicians. So that’s staff we already have access to, staff we don’t want and staff we’ve never heard of.
  • One hundred per cent reimbursement!! In case you’ve forgotten already, that applies to staff we already have access to, staff we don’t want and staff we’ve never heard of. It’s like being given free air.
  • More doctors in general practice!!! Apparently, 500 extra trainees working for 24 rather than 18 of their 36 months in general practice represents ‘one half’ of the 6,000 extra doctors provided. Despite being supernumerary, right? You might want to check the maths on that.
  • Improved service specifications!!!! The blurb proclaims that those horrific specs have been whittled down to just three pages. Amazing what you can do with a smaller font. As far as I can tell, words have been arranged and wriggle-room added, but the song remains the same.
  • A £20,000 one-off incentive payment for new partners!!!!! Because that’s the barrier for prospective new partners, isn’t it? Fears around crushing responsibility, crippling workload and the prospect of ‘last man standing’ are nothing in the face of an envelope stuffed with used fivers.

For every one who says, ‘That’s good,’ there will be many more saying, ‘That’s it.’ With trumpets

And so on and so forth.

The most depressing thing here is that, once again, the point has been missed and the direction of travel set. The problems paralysing general practice are too much work and too much responsibility. These are not solved by giving us more of each. I’m exhausted, and there is no way that pseudo-help and arms-length bribes are going to help.

A few may be seduced by the shiny new package. But for every one who says ‘That’s good,’ there will be many more saying ‘That’s it.’ With trumpets.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at or follow him on Twitter @doccopperfield