The government will seek to make significant changes to GP contracts in coming years, including standardising practices’ income and introducing a new set of community services, it has announced.
The Department of Health said on Tuesday it wanted to standardise “’core’ funding between GP practices over a seven year period starting in April 2014”. Currently there is significant variation between practices’ funding.
It is also seeking to scrap a large part of the quality and outcomes framework – the GP pay for performance scheme – from next year. The DH wants to move funding for the QOF’s organisational indicators – which reward measures such as record keeping – into new practice-based community services and other schemes.
It also wants to introduce all the clinical indicators recommended by the National Institute for Health and Clinical Excellence into QOF. It said it was offering a 1.5 per cent increase in the GMS contract for 2013-14 alongside the changes.
The changes would lead to a significant change in income for some practices.
The British Medical Association GPs committee has indicated it is concerned about the proposals, but it is currently unclear how it will react to the different parts of the plan.
The DH indicated some measures had been discussed and agreed by the BMA. However, it said it had been unable to agree contract changes for 2013-14. And the DH said if it was “unable to reach agreement with the BMA, [the government] will move to a period of formal consultation” to impose the changes.
In order to standardise practices’ core funding, the DH said it proposed “phasing out the minimum practice income guarantee and achieving equitable ‘core’ funding”. The DH has proposed phasing out MPIG – which compensates small practices – for some years, but many still receive it.
The DH said it would calculate a new capitation sum for each practice, including new adjustments for deprivation. With the NHS Commissioning Board, which will hold primary care contracts from April, it would move “in a controlled and phased way towards equitable funding for all GP practices, based on the numbers of patients they serve with an appropriate weighting for demographic factors that affect relative patient needs and practice workload”.