Since the proposed new contract for general practice in Scotland was published, there has been a lot for GPs to digest and consider ahead of December’s poll of the profession.
The word that I have most commonly heard used to describe the proposed new GP contract is ‘ambitious'. That description is not only good, it is essential.
The status quo has left too many practices struggling to cope with vacant posts, too many GPs burning out as a result of unsustainable workloads, and not enough young doctors making the choice to have a career in general practice.
We needed a bold, aspirational new vision for general practice in Scotland and that is what we have been presented with.
> How the GP role will change under the new contract
> How the new contract takes away the burden of premises
> Rural GPs fear 'extinction' under new deal
> Read the proposed Scottish contract deal in full
At the heart of the proposed contract is the need to address workload, with plans for a wider range of professionals in the community, such as more nurses, pharmacists and physiotherapists, that patients will be able to access directly. This will help to reduce the burden on GPs and allow us to focus on undifferentiated presentations, complex care, and providing a leadership role to the wider primary care team.
Responsibility for providing treatment room services, vaccinations, and pharmacotherapy will transfer to health and social care partnerships, freeing up practice time and resources, but the current funding will remain with GP practices.
The proposed new contract also recognises that those practices with higher workloads need more support if their quality of care is to be maintained. The funding formula that underpins general practice will change if the contract is implemented, so that while every practice’s current income is protected, those practices with the highest workloads will receive more support, most notably those practices with higher numbers of elderly or deprived patients.
The practices that need protection will receive it, with no time limit and such funding uplifted in future funding decisions. That guarantee will be hugely important to the practices that need it and cannot be emphasised enough.
The contract will also take steps to reduce the business risk that comes with being a GP. That will make it more appealing for younger doctors to become GP partners, helping with the difficulties in recruitment and retention. The contract preserves our autonomy and the best parts of being independent contractors, while reducing the business risks that GPs across the country face.
The new arrangements proposed in the contract for GP premises, GP information technology and information sharing are significant too. The effect of these arrangements will be a substantial reduction in risk for GP partners in Scotland, and a substantial increase in practice sustainability.
The NHS relies on a healthy general practice to function effectively. It is the part of the NHS that the greatest number of people interact with and all of us depend on being able to access primary care services when we need them. We cannot allow the difficulties in our GP surgeries to go unaddressed.
The proposed contract offers much needed hope to many in general practice and can put it on a firmer footing for the years ahead.
- Dr Neil MacRitchie is a GP in Grampian and a member of the Scottish GPC