‘Poor delivery' of GP contract scrutinised

The GP contract faces scrutiny by the same team that last week reported that the NHS consultant contract had rewarded the same or less work with a pay rise of 27 per cent.

Investigators from the National Audit Office (NAO) are conducting a pay modernisation study of the GMS contract in the wake of concerns that it has not delivered value for money to the NHS.

The investigation is likely to follow the model used by the NAO to examine the consultant’s contract.

Some 6,000 consultants — almost one in five of the workforce — were asked 38 questions about factual issues, such as hours and duties, as well as open questions about unhappiness with the old contract.

The NAO is also expected to ask for the views of primary care organisation (PCO) chief executives, medical directors and finance directors and to interview staff from PCOs and SHAs, following the methods used in the consultant contract survey.

Results of the GP contract investigation are expected by the end of the year, the NAO said.

The results risk refuelling the row between the profession and the government over media spin to put GPs in a bad light.

The NAO said the consultants’ contract had yet to deliver value for money but reserved its sharpest criticism for the DoH for failing to collect robust evidence when negotiating the contract and underestimating the real hours that consultants worked.

The DoH modelled the new contract on consultants working an average 43 hours a week
and ended up having to pay them for working an average of over 50 hours.

Sir John Bourn, head of the NAO, called for all new DoH policies to be based on accurate evidence and outcomes to be financially modelled before implementation.

The NAO thinks lack of financial controls mean that the new consultant contract may have cost £200 million more than budgeted.

Sir John was also scathing about the link between workforce expansion and productivity, showing that although the number of consultants rose by 13 per cent in the two years following the contract the amount of consultant-led activity rose by only 4 per cent.

Consultants told the NAO that they were delivering less patient care than under the old contract.

Only just over two thirds of trusts believed that the new contract improved recruitment.

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