We are committed to what we do for our patients but are seeing a steady erosion of practice income.
We have seen 50 points for access removed from the quality framework. Last financial year an enhanced service was commissioned that enabled practices to recover the value of the lost 50 points. This year, to date, an access enhanced service has not been commissioned and, if it eventually is, we are concerned that it will not cover the lost 50 points.
We are being encouraged to adopt Agenda for Change terms and conditions but, unlike secondary care, with no funding. We have adopted the Agenda for Change salary levels but cannot afford the full package. The potential is there for increasing recruitment and retention difficulties.
The zero inflation rise for the last two years is also taking its toll. Practice expenses are rising, in many cases above inflation.
With opportunities to generate income being eroded yearly, practices are significantly worse off.
Usually if you are paid less you would expect to do less. The opposite is true in our case, with continual political and media pressure to do more for the same or less money.
Dr Philip Speakman, Buckley, Flintshire.