Almost half are considering opting out of the unplanned admissions DES agreed for 2014/15 – worth about £20,000 per average practice – amid fears it will consume huge amounts of practice time.
The findings suggest GPs remain unconvinced by a deal hailed as a breakthrough by GP leaders and the DH after the imposed 2013/14 contract was blamed for a sharp rise in practice workload.
Under the 2014/15 contract deal, 38% of the QOF will be removed to reduce bureaucracy – but a third of GPs now believe the performance-related pay framework should be scrapped. Of 328 GPs responding to the poll, just 24% said the potential loss of up to £10,000 in practice income from the transfer of QOF points into core pay was not a price worth paying for freeing up staff time and more predictable funding.
Many GPs are concerned about the growing divide between practice contracts across the UK, after this year’s negotiations became the first to be conducted almost entirely independently for each UK nation.
A total of 64% of GPs said the GP contract should be identical UK-wide, while 82% of respondents warned that talks on separate deals for each part of the UK weakened the position of BMA negotiators.
Uptake for a patient choice DES taking effect from April may also be limited, with just 30% of GPs reporting that their practice will sign up.
The DES will allow patients to register at a practice away from where they live, but potentially nearer where they work.
Despite low levels of interest from practices, the 30% figure could be considered a success given that in parts of England, a pilot scheme last year struggled to attract any practices or patients willing to participate.
Survey respondents said workload would remain high because writing care plans for patients under the unplanned admissions DES would create significant extra work and practice performance on retired QOF targets would still be monitored.
One London GP said: ‘Being a named GP for over-75-year-olds will increase workload, and the QOF standards will still be expected, but we won’t get payment for this.
‘Anything that states bureaucracy will be reduced seems to come with a new raft of forms to submit.’
A Manchester GP wrote: ‘Yet again we are going to do more for less and even though we are told not to do activity that is not commissioned, we have to for our patients, even when hospitals fail to deliver what they are actually funded for.’
GPC chairman Dr Chaand Nagpaul said the GP contract could not address all factors that drive up practice workload. But he said the deal would help GPs ‘focus on work that is clinically more appropriate’. Dr Nagpaul said the changes would remove ‘highly demotivating’ box-ticking work that GPs have been forced to do and would reduce bureaucracy.
He added: ‘Now our priority is to make sure that at a national level, there is proper recognition of the escalation of workload on practices through work moving out of hospital and from an ageing population. We want the government to put in place a national policy to ensure care moving out of hospitals is resourced.’