Contract deal 'weeks away' as out-of-hours compromise emerges

A compromise deal on GP out-of-hours responsibility could see GMS contract negotiations concluded within weeks.

GPC out-of-hours lead Dr Peter Holden said he was prepared to see GPs take responsibility for overseeing the quality of local services.

Changes to the GP contract for 2014/15 could hand GPs 24-hour responsibility for the care of frail elderly patients, and could involve changes to access requirements, shrinking of the QOF, and changes to out-of-hours responsibility.

Health minister Lord Howe said negotiations were 'moving to a very constructive stage' with GPs and employers 'aiming for the same endpoint'.

GPC deputy chairman Dr Richard Vautrey told delegates at the Best Practice conference in Birmingham that talks could end 'within weeks'.

'We intend to conclude things as soon as possible,' he said. 'Our experience last year, however, was that we went right up to the wire. We don't want to be in that situation again.'

Outlining pressures faced by practices following last year's contract imposition, including QOF changes, the phasing out of MPIG and the PMS review, Dr Vautrey said the imposition had made care worse.

Speaking to out-of-hours providers at the conference of Urgent Health UK, Dr Holden rejected a return to pre-2004 individual responsibility and ruled out responsibility for the quality of services GPs do not provide.

But he said GPs could provide 'oversight of quality'. 'I think we can do that, with some caveats,' he said.

Health secretary Jeremy Hunt has said GPs should take back control of out-of-hours and blamed the 2004 contract for pressure on A&E.

Dr Holden said GPs would have to make concessions. 'That is the bottom line. Given we haven't the workforce, what can we do to help the system?'

Meanwhile, calls for CCGs to take control of GP contracts and commissioning were ruled out by NHS England deputy medical director, GP Dr Mike Bewick.

Dr Bewick told the Best Practice event: 'It would be impossible (for CCGs to commission primary care) immediately.' But he hinted the change could be evolutionary. 'It has to be done in partnership.

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