Practices taking part are already likely to have received an average aspiration payment of £4,000. GP leaders warned this could be clawed back if practices pulled out.
Lawyers warned that practices could also be liable to pay damages if they withdrew. Many practices have amended their contracts to include the DES.
The dispute relates to the patient survey that will determine how much achievement pay practices receive for access. GP leaders fear responses will be negatively affected after the DoH insisted on adding questions on practice opening hours, which are not part of the DES.
GPC chairman Dr Hamish Meldrum said that the original list of questions related directly to the DES standards, including ease of telephone access, booking advance appointments and access to a GP within 48 hours.
But the DoH has insisted on a question asking whether patients are dissatisfied that their surgery does not open at weekends, or in the evening or early morning.
‘We felt this was a departure from what we had agreed, and practices should seriously consider whether they continue to participate,’ Dr Meldrum said. The GPC did not oppose asking patients about opening hours, he added, but the survey was not the place to do it.
GPC member Dr Trefor Roscoe said his practice would lose £20,000 for dropping the DES, but backed the advice to withdraw: ‘I think it’s about time the profession said “no”.’
But it may be tough for some practices to pull out. Cleveland LMC secretary Dr John Canning said his practice had altered its contract three weeks ago to include the DES.
‘Quite a few practices will have committed themselves to the DES in their contracts. I would be surprised if lots pull out,’ he said.
Lynne Abbess, a partner at solicitors Hempsons, said contracts could only be altered with the PCT’s agreement: ‘If you pull out anyway, you could be liable for a claim of damages.’
A DoH spokesman called the decision to reject the DES ‘disappointing’.