How the GP contract will change in 2012/13
By Nick Bostock, 10 November 2011
Pay for GP practices across the UK will be frozen again in 2012/13, negotiators revealed last week. Below, GP sets out in detail how the change will work.
A 0.5% uplift in overall general practice funding will be delivered through an increase of around £3 to the value of each QOF point.
Practices will have to work harder to maintain their current levels of QOF achievement because thresholds have been raised for many indicators.
Changes to enhanced services have also been agreed.
The majority of changes apply UK-wide, but practices in England face additional, and significant, reforms that will extend practice boundaries in a bid to boost patient choice. Practices in England are also likely to be contractually required to join commissioning groups if the Health Bill is passed.
The only increase to core pay will come from cash recycled from the scrapped directed enhanced service for osteoporosis. But the rise is so small that BMA experts believe just 15 practices will be lifted off reliance on the minimum practice income guarantee in 2012/13.
A statement from GPC negotiators from all four UK countries as the deal was announced said: 'We believe that the changes represent the best possible agreement that your negotiators could reach in these unprecedented and challenging economic times and are confident that GPs in England, Scotland, Wales and Northern Ireland will continue to work within their contract to provide the best possible service to their patients.'
The funding increase will not match rising practice expenses, which have already led to a decline in practice profits. Very few practices will be lifted off the minimum practice income guarantee in 2012/13 because of the tiny addition to core pay.
|PMS AND OTHER IMPLICATIONS
In a cash-poor NHS, locally negotiated contracts are vulnerable to local cuts in addition to the national pay freeze.
No major changes to DESs for 2012/13 - the DoH appears to prefer quality and productivity indicators in QOF as a vehicle for imposing new targets. Could practice boundary pilots be converted into a DES for 2013/14?
For each practice in England to negotiate an 'outer boundary' sounds like a lot of work. This may prove complicated as PCTs shift into clusters and because of different approaches in rural and urban areas. The pilots suggest the DoH could yet push for more radical changes in future.
Practice workload will rise as 'retired' indicators must still be delivered, points are stripped from indicators that remain, and thresholds for achieving QOF points are pushed up.
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