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Sweeping changes planned for GP contracts

Prime minister David Cameron announces new seven-day GP contract for England from 2017, while Scottish health minister Shona Robison confirms QOF will be scrapped north of the border.

David Cameron revealed details of a new voluntary seven-day integrated care contract for general practice at the Conservative Party annual conference in Manchester this week.

The new contract, to be launched in April 2017, will integrate GPs with community nurses and other health professionals using money from the £10bn new NHS investment announced previously, the government said.

The contract will be based on the principles of more funds for primary care, more control for GPs over the way they work, and more time to care for patients and services seven days a week, the government said. It will abolish the QOF, which the government said was a bureaucratic burden. 

NHS England said the contract will be developed as part of the new care models vanguards programmes to support the integration of wider primary and community care services. The commissioning body said previously that it would develop new contractual options to encourage GPs to join new care models. As well as simplifying the QOF, it has suggested merging GP funding with other providers’ streams. 

A new ‘patient guarantee’ will require CCGs to ensure every patient has seven-day access to services by 2020, the prime minister said.

However, GP leaders said they had not been consulted about the contract and warned it would not address the root causes of pressures on services.

Changes in Scotland

Meanwhile, Scotland's health secretary Shona Robison revealed that the Scottish government has started started work on redesigning the new Scottish GP contract for April 2017. Speaking at the RCGP annual conference in Glasgow last week, she said ‘radical reforms’ will see GPs take on the role of expert generalists in multidisciplinary teams where they will not always be the patient’s first point of contact.

Ms Robison is listening ‘very carefully’ to concerns from GPs on the front line, which will have a direct impact on how the contract will change.

As part of the changes, work on ‘dismantling’ the QOF has already begun. Scottish GPC chairman Dr Alan McDevitt confirmed toGPonline in March that QOF would be scrapped in the next contract.

But Ms Robison said the QOF could be absent from the Scottish contract from next year. A transitional arrangement for quality will be implemented for 2016/17 ahead of the new contract.

‘The QOF has delivered many innovations, but its time has passed,’ she said. ‘Scottish GPs need a new and different future, starting in 2016.’

Ms Robison added: ‘This commitment to the transformation of primary care comes with a commitment to invest. In Scotland we spend £12bn a year on our health service. Of that, £770m is spent on general practice. In addition, we recently announced a further £60m primary care transformation fund.’

The government is also in the midst of discussing a further £2.5m to boost GP recruitment and retention in Scotland, especially to improve recruitment to rural and deprived areas.

‘I can give you my absolute assurance that invest in primary care is one of my key priorities,’ she said.

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