Welsh GP leaders to outline major contract overhaul later this year

GP leaders in Wales say the contract deal for 2017/18 will help slow down practice closures across the country, and hope to outline plans for a more radical 2018/19 deal by Christmas.

GPC Wales deputy chair Dr David Bailey
GPC Wales deputy chair Dr David Bailey

The 2017/18 GP contract presented to the profession at this year's Welsh LMCs conference in Newport will bring a £27m investment in general practice.

Support for GPs on indemnity costs and improved sickness payments - similar to the deal announced in England last month - have been welcomed by the BMA in Wales.

But talks have begun on further changes to funding for indemnity, plans to increase GP collaborative working and the future of the QOF that could significantly reshape the GP contract in Wales from April 2018, GPonline understands.

GP contract review

GPC Wales chair Dr Charlotte Jones said as the 2017/18 contract was announced that the deal was 'part of a longer piece of work to review the entire contract and make it fit for the future'.

Speaking to GPonline, deputy chair Dr David Bailey said the GPC was talking to the Welsh government to sort out 'the finer details' of the 2017/18 deal, and that 'more significant discussions' were underway for 2018/19.

'We have had preliminary discussions on indemnity, practices working together more, what we do with QOF - and hope to outline this to the profession this side of Christmas,' he said.

Dr Bailey said the deal could bring a 'step change' for the GP contract in Wales, and confirmed that Welsh GP leaders were monitoring closely changes in Scotland - where the QOF has been scrapped - and 'trying to pick up the good bits'.

The GPC Wales deputy chair said he believed the 2017/18 deal would significantly improve practice resilience and help ease pressure, and would help to slow down practice closures.

GP workload

He said GP leaders felt they were 'in a decent place' in terms of their relationship with the Welsh government, and was 'pretty content' that contract changes implemented through the latest contract deal were aimed at patients rather than political priorities.

Directed enhanced services around diabetes and support for residential and nursing care populations would be 'genuinely beneficial for patients', he said, and would help ease pressure on hospitals.

Although higher overall prevalence meant that GPs still work harder for their funding than their counterparts in England, Dr Bailey said that there was a 'feelgood factor' and a sense that the government was trying to improve primary care.

Better sickness payments would significantly relieve pressure on small practices, he said. 'For small practices at the moment, one partner off long-term sick is a disaster. The deal we have is similar to England and actually significantly promotes resilience for more vulnerable practices.'

He added that the deal would also promote development by GP clusters of services 'responsive to local needs' that could ease pressure on GPs by providing new options to refer patients to.

'We will see dividends over the next 12 months,' he told GPonline. But he added: 'The primary issue is not about the contract, but actual recruitment. We are starting to look at ways to promote federated working, mergers, attract more trainees and try to make Wales more attractive and get more potential GPs into training in Wales, plus contract change.'

He added that there was work to do on getting LHBs to 'step up on premises' and helping to mitigate risk for GPs particularly in areas where there was a workforce shortage.

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