UK-wide GP contract talks scrapped as England faces 24/7 NHS pressure

GMS contract talks will no longer be carried out on a UK-wide basis from this year, in a move that could increase QOF variation and open the door to making GPs in England responsible for patient care around the clock.

Dr Richard Vautrey: GPC negotiating team will remain UK-wide
Dr Richard Vautrey: GPC negotiating team will remain UK-wide

NHS Employers has confirmed that it has not been asked to represent the Scottish or Northern Irish governments in GP contract negotiations for 2014/15.

The organisation will represent NHS England in talks on the contract, and will support the Welsh government on the clinical elements of QOF.

Enhanced services have been negotiated separately since the new GMS contract took effect in 2004, and the distribution of some elements of core funding has varied from country to country within the UK.

QOF variations were introduced between the UK countries for the first time from 2013/14, with different thresholds for indicators taking effect.

With the gradual phasing out of MPIG top ups to core funding set to begin in England from April 2014, but not in the rest of the UK, the GPC faces a battle to retain the UK identity of the GP contract.

GPC deputy chairman Dr Richard Vautrey told GP: ‘Since 2004 there have always been variations of the contract specific to each country but even now there is more that unites us than divides us, with the core framework of the contract remaining common in all parts of the UK.

‘This is why the GPC negotiating team will continue to include the chairs of GPC in Scotland, Wales and Northern Ireland.’

Plans for separate contract talks across the UK come as NHS Employers hailed an agreement with the BMA to open talks on a new consultants’ contract as a ‘stepping stone towards future advances in seven-day NHS services’.

GPC member and Wessex LMCs chief executive Dr Nigel Watson said this would have implications for talks on the GP deal.

Health secretary Jeremy Hunt has called for GPs to be made responsible for patients health and social care on a 24/7 basis.

Dr Watson said: ‘We would argue there already is seven-day-a-week general practice, called out of hours. There are senior GPs working out of hours. The bit we do need to address is there is a variable quality of out-of-hours care and certainly in some areas there is variability in what would be delivered to patients in and out of hours.

‘Where [Mr Hunt] is coming from is that over time more patients have been registering with practices not GPs, and some vulnerable elderly patients don’t know where to go.’

He said there was a ‘debate to be had about how best to organise care for these patients, but warned that changes would require additional resources.

Dr Vautrey warned that any move towards a seven-day NHS must avoid ‘spreading existing resources too thinly and ending up with a poorer quality service all the time’.

He said: ‘If you wanted a seven-day routine service in general practice equivalent to what we offer already we would need to double the number of GPs and resources for general practice. We would question whether that is what the taxpayer wants to pay for.’

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