More than £160m will be taken away from rewarding GPs for “bureaucratic tick box exercises”, as the government stands firm on its proposal to remove organisational indicators from the quality and outcomes framework (QOF).
A consultation on the proposed changes to the GP contract has been launched by the government after a negotiated settlement could not be agreed “following a series of discussions” between the British Medical Association (BMA) and NHS Employers.
Health Secretary Jeremy Hunt said the £164m traditionally set aside for GP ‘office’ functions such as record keeping, will now be re-directed into “actions that directly benefit patients”, including better control of blood pressure and cholesterol, to prevent heart attacks and stroke and assessing patients at risk from dementia.
It is estimated the proposed changes to the 2013/14 GP contract could mean around 1.5m people will receive “better care” next year and 3.5m people by 2014/15.
“Getting patients an earlier diagnosis of dementia and supporting those with long term conditions are my main priorities. I want GPs to take the lead in making this happen,” said Hunt.
“Standards of care in this country must be world class - and we should continuously strive to improve. This is why the GP contract must change.
“Our proposals will make sure we support the patients most in need and will help save lives in practices across the country. We believe GPs can and will rise to these new challenges.”
Under the government proposals, the Minimum Practice Income Guarantee (MPIG) will also be phased out over seven years and QOF reward thresholds will be increased.
Dr Laurence Buckman, chair of the BMA’s GPC, criticised the government for the “unacceptable” way it has handled contract negotiations.
He said while some of the government’s proposed changes to the 2013/14 GP contract are “good” and may appear “attractive”, ministers have not “fully considered” the overall impact on practices of all the changes being implemented together.
“This could make it difficult for some practices to maintain the level of care they currently offer, let alone increase their capacity to meet the demands of these new proposals,” said Dr Buckman.
“The BMA will closely analyse the details of these complex proposals. We hope that ministers intend to engage in a meaningful discussion and that they will listen and act on concerns that are raised, particularly where their proposals are unworkable or will lead to unintended consequences. We would be extremely disappointed if this consultative process was a rubber-stamping exercise for their existing plans.
“The unacceptable way the government has handled these negotiations should not set a precedent for future discussions.
Hunt said he had “listened, responded and fully considered” alternative proposals put forward by the BMA GP Committee (GPC). He insisted it was “reasonable” to consult on his proposed changes to the contract “in the absence of an agreed settlement”.
The BMA GPC and other primary care organisations have 12 weeks to respond to the government’s proposals on the GP contract.