A senior member of the organisation's negotiating team told GP that although GMS would retain a national core, parts of the deal would ‘increasingly go for local negotiation'.
However, the GPC is deeply opposed to plans to dilute the national contract, and the proposals could deepen the rift that saw GMS contract negotiations collapse last year.
The ideas could also strengthen the GPC's resolve to bypass NHS Employers in future contract discussions. Senior GPC figures have mooted the possibility of discussing the contract directly with the DoH and sending evidence to the Doctors' and Dentists' Review Body without consulting NHS Employers (GPC negotiators threaten to boycott NHS Employers - GP, 20 April).
Grass-roots GPs are similarly opposed to local contracts. A recent GP survey found that 80 per cent of GPs wanted to retain a UK-wide contract (72% of GPs back call for fewer contracts - GP, 2 March).
Chris Dowse, head of primary care contracting for NHS Employers, said that the DoH planned to give the NHS Board a greater role in setting the contract, to ensure it was more closely aligned with other NHS priorities. The PCT Network established last year would feed the collective views of PCTs to the NHS Board.
'There will always be a nationally negotiated core, but increasingly elements will go for local negotiations,' Ms Dowse said. 'We are trying to get value for money, so we wouldn't want to see lots of local negotiations with different pricings.
'But I don't see why an element of the quality framework couldn't be costed nationally, but set locally; it could be that you have x number of points available for local use.'
Some issues of concern in different UK countries and localities simply did not figure in the national agenda, she pointed out.
But GPC deputy chairman Dr Laurence Buckman said: 'You can't have quality judged differently in different parts of the country.'
The national deal protects patients from receiving variable standards of care and prevents PCOs from attempting to cut deficits by scrapping elements of healthcare, he said: ‘The idea that you can re-hang quality markers to include or exclude certain patients is outrageous.'
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