THE government’s proposed changes to the GP contract in England risk putting targets before patients and could seriously destabilise local patient services, GP leaders warned yesterday.
The warning came in the British Medical Association’s (BMA’s) response to the government’s consultation on proposals to make sweeping changes to the English GP contract from April 2013.
As well as an analysis of the workload and funding implications for GP practices, the BMA’s submission contains interim findings from a survey of GPs with nearly 8,000 responses.
The government’s proposals will see general practice facing a raft of new targets that will divert time and resources towards box ticking and administrative work, and additional workload responsibilities in a number of clinical areas.
At the same time, changes will be made to how resources are allocated, including higher targets for GPs to reach in order to retain funding through the Quality and Outcomes Framework (QoF) and reductions in the central funding many practices receive.
In response to the government’s proposals, the BMA’s survey found that:
• Almost six out of ten (58%) GPs said they expected to have to make changes to the services in their practice to compensate for the impact of the government’s proposals.
• Of this group, just over half (54%) said their practice would have to reduce access to patients.
Of these respondents, nine out of ten (91%) said they would not be able to see patients for routine appointments as quickly as they currently do, while seven out of ten (72%) thought they would have to reduce the number of consultations offered to free up time for the new workload.
A similar number (75%) expected to reduce the range of services offered to patients.
• In addition, out of this group eight out of ten (82%) expected to make changes to staff working hours or employment. Of these, roughly one in five (22%) expect to make clinical staff redundant and over a third (35%) would have to lay off administrative staff.
• An average practice will lose at least £31,100 a year in funding from 2014/15 owing to changes that make it more difficult for practices to achieve funding through the QoF and other budgetary changes.
Some practices will see their budget cut even more as alterations are made to other funding streams designed to fund GP practices with complex patient populations.
Dr Laurence Buckman, Chair of the BMA’s GP Committee, warned: ‘The changes would make it difficult for practices to maintain the level of care they currently offer while introducing an even greater focus on targets and box ticking at the expense of holistic, patient-centred primary care.’
‘GPs will also struggle to reconcile the government’s desire to increase workload and introduce new priorities with the significant constriction of resources and capacity heralded by these proposals.’