Editorial: Finding the positives in NHS reforms

Spring - and change - is in the air. Regular readers of GP will remember survey results finding that one of your criticisms of us was that our news coverage was becoming 'too gloomy'.

Indeed, GPs as a profession have always been renowned for their skill at making the best of a bad job.

The Scottish LMCs conference (page 18) will have finished by the time you read this and was expected to debate whether there should be a formal split from the UK GMS contract.

GP workload, coupled with the need for funding work moving from secondary to primary care, were also likely to feature.

But it wasn't all bad news. LMCs also put forward motions congratulating GPC Scotland on negotiating contract changes 'less damaging than those imposed in England'.

The Welsh LMCs conference also took place this month (page 23), with a warning general practice is being 'strangled' by rising workload and could become unsustainable as a workforce crisis bites.

However, there was recognition that ministers agreed not to press ahead with plans to axe MPIG over seven years from 2014 that look set to be implemented in England.

On page 29 we analyse how health and wellbeing boards (a key feature of NHS reforms in England) will work. Some believe boards will be the new 'system leaders', but a leading GP maintains that CCGs are 'where the real action will be centred'.

Boards could prove to be a strength for CCGs facing unpopular decisions, as they include people with experience of engaging with communities.

One of the concerns, that GP local enhanced service funding will simply be absorbed by councils plugging their own gaps, is examined in more detail in our exclusive investigation (page 6).

The future of enhanced services is clearly a worry for many practices. This is a period of upheaval - and a time of uncertainty for GPs about funding.

At the time of writing, the Doctors' and Dentists' Review Body report into GP pay and DH response to its consultation on GMS changes were awaited. GPs will hope that they will contain more than minor victories for the profession.

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