LMCs back call for a payment by activity contract

The current GP contract 'should be replaced by a payment by activity contract' which directly links workload to resource, GP leaders have said.

Dr Kelly called for a payment by activity contract
Dr Kelly called for a payment by activity contract

GPs narrowly backed the call made at the 2015 LMCs conference by Kent LMC’s Dr Jim Kelly, with 53% voting in favour of the shift to payment by results. They unanimously voted that the current contract is ‘unfit for purpose’.

Last year, Dr Kelly memorably broke into a rendition of Elvis Presley, calling for a ‘little less conversation, a little more action please’ in a bid for a payment by activity contract, but the motion was ultimately lost.

This year, he appealed to conference with a thinly-veiled allegorical tale about ‘Jim the window cleaner’ and his quest to be properly paid for the work he did, which went down well with attending GPs.

Dr Rob Bailey from Cambridgeshire LMC spoke against the motion. ‘My heart says this sounds as though it’s a good idea, but my head says it is not,’ he said. ‘Wouldn’t we risk breaking the link between patient lists by introducing target-driven incentives?’

GPC chairman Dr Chaand Nagpaul cautioned delegates ahead of the vote. He said: ‘I think there are some issues, but I think conference needs to decide on them. I just want to say we are seeing real problems with paying by results in hospitals. And NHS England is minded to replace this, so I just wanted you to consider that.’

The vote was close, with 53% of attending GPs voting in favour compared with 42% against and 5% abstaining.

In other sections of the motion, attending GPs unanimously backed statements which said that the current formula-based core contract ‘failed to recognise’ the ever-increasing demands faced by 21st century general practice and that it did not incentivise the expansion of general practice needed to implement the Five Year Forward View.

GPs also backed calls for ‘a halt to the demise of seniority payments’ and for GPs to receive an ‘immediate increase in resources to reflect the increase in consultation rates’.

Another backed motion called on the DH ‘to move more funding into core contract baselines’.

* Video: Why general practice should be paid by activity: Dr Jim Kelly

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