GPs reject contract overhaul

Just 1% of GP partners back GMS contract changes that the government plans to impose from April, a poll by GP magazine reveals.

Of 431 GP partners who responded to the poll, 83% said they opposed the changes. The vast majority of GPs also said plans to raise upper thresholds for some QOF indicators to 100% were unworkable.

Below, GP reviews key details of how the contract changes will work. Consultation on the plans is open until 26 February.

GPs will be forced to work harder to maintain existing income and practices are unlikely to find out whether they will receive a pay rise for extra work until the Doctors' and Dentists' Review Body makes pay recommendations, expected in February. But any rise is unlikely to offset the impact of changes to practices' basic income and to QOF pay.

BMA leaders say QOF cuts will slash £31,000 from practice income in 2013 alone. Plans to axe MPIG top-ups to core funding over seven years from 2014 will mean six-figure cuts everywhere but Scotland, where a separate deal has been agreed.

A similar overhaul will be imposed on the 35% of practices in England on locally agreed PMS contracts.

Jon Ford, head of the BMA's health policy and economic research unit, says about 4% of GMS practices in England receive more than 25% of core funding from MPIG top-ups. For them, he says, the changes will be 'seriously destabilising'.

Dr Nicki Singer's 8,200-patient GP practice in Hackney, London, receives £180,000 from MPIG. 'This is going to be quite a big hit,' she told GP. 'It's the majority of our staff bill.'

The DH has urged the profession to 'rise to these new challenges'.

One GP responding to the poll wrote: 'I do not see how I can be expected to take on an increased workload. As a practice we are already at saturation point.'

Another respondent said: 'As usual lots more work, much of it based on poor evidence at a time of significant drop in income with rising expenses.'

A third GP wrote: 'I feel that imposition of this continues to devalue our profession. Increasing the workload and once again reducing payment to our already overworked undervalued sector. Seems that the government is trying to force GPs into a max exodus from the NHS and bring an excuse to privatise healthcare.'

Others said they planned to retire early, and expressed fears about trainees being put off careers in general practice.

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