GP contracts in England and Scotland face rapid divergence

GP contract agreements in Scotland and England could move further apart than ever next year, after GPC Scotland confirmed it will 'pursue minimal changes' in 2014/15 while England undergoes a major overhaul.

Dr Alan McDevitt: developing a 'more Scottish' contract

Earlier this month NHS Employers and the GPC confirmed that UK-wide negotiations on the GP contract would be scrapped for the first time.

In England, MPIG top-ups to core pay are set to be cut by one seventh of their total value in 2014/15, with the funding redistributed among practices across the country. This is the first step in a seven-year process that will phase out MPIG in England by 2021.

Scotland, along with Wales and Northern Ireland, has opted not to begin phasing out MPIG.

A UK split emerged for the first time in 2013/14 on QOF, with Scotland, Wales and Northern Ireland rejecting changes imposed in England that will force GPs to hit increasingly high thresholds to earn maximum QOF points.

If England adopts changes to QOF indicators and new targets proposed for 2014/15 by the NICE committee that advises on changes to the framework, gaps between GP contracts across the UK will widen to an unprecedented level.

Both the GPC and health secretary Jeremy Hunt have suggested that they are open to substantial changes in 2014/15, with both calling for a reduction in bureaucracy.

In a letter to GPs in Scotland, GPC Scotland chairman Dr Alan McDevitt said that implementing changes to the contract this year had been challenging, and that roadshows had revealed the profession wanted 'a period of contractual stability'.

'Therefore, the Scottish government and GPC Scotland agreed in principle to pursue minimal changes for the contract in 2014/15,' he said.

'Recently the Scottish government notified us that it would not be involved in the UK negotiating process, which means that there will not be a four-country negotiation this year. We do, however, have an understanding with the Scottish government that if the English negotiations achieve any changes that both sides agree would be beneficial for Scottish GMS arrangements and fit with our aspirations, we wiill look to introduce these in Scotland.

'There is still a UK framework for the GP contract but as the health service in England diverges from that in Scotland, it is appropriate that we work with the Scottish government to produce a more Scottish contract that reflects our own situation. I hope that following the constructive talks we held last year, the Scottish government continues to work in partnership with the profession.'

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