Editorial: A scaled-back QOF would cut GP stress

Health secretary Jeremy Hunt told us exclusively in our previous issue (GP, 5 August) that the GP contract needed a 'fundamental rethink', signalling perhaps its biggest overhaul since 2004.

On page 18 of this issue, we feature an interview with Cornwall GP Dr Beth McCarron-Nash, who became the GPC's youngest negotiator on her election to the post in 2008, lost her seat in 2012, but was re-elected this year.

Dr McCarron-Nash describes the new team of negotiators under recently elected GPC chairman Dr Chaand Nagpaul as 'very strong' and says its new leader is an 'excellent negotiator'.

As a fresh face leading the GPC team at the GP contract negotiating table, Dr Nagpaul would do well to consider the findings featured on this issue's cover.

The two results from our exclusive survey which we thought would resonate most with GPs were that 77% of GPs say the job has become more stressful over the past year and 40% carry out between 40 and 60 consultations a day (page 6).

A new army of GPs appears unlikely to enter the fray any time soon, with even the possibility of reinforcements looking over-optimistic.

The RCGP last month warned that England was heading for a shortfall of 16,000 GPs by 2021.

So perhaps a 'fundamental rethink' of the contract wouldn't be such a bad thing? A glance at GP's Letters page (page 21) would reveal a familiar unhappiness with the bureaucracy, red tape and box-ticking that characterises the worst of the GP contract, with QOF at its heart.

It's ironic, because that box-ticking equals cash and is becoming increasingly important at a time when so many GP practices are seeing their funding reduced.

GP contract funding is a delicate balance of global sum, QOF and enhanced services.

But its complexity should not dissuade the GPC negotiators from modelling a range of different options to look at what would happen if box-ticking and bureaucracy were reduced as the QOF was scaled back.

The future health of the profession deserves nothing less.

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