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UK ‘could do with alternative GP contract’

19 January 2012

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The UK should emulate the US in offering a voluntary alternative GP contract promoting the quality and integration of care, the Chief Executive of the King’s Fund has claimed.

Following a presentation by Dr Dana Safran of the Blue Cross Blue Shield of Massachusetts at a King’s Fund conference, Professor Chris Ham said there is a “huge opportunity” to use the government’s health reform to prioritise the strengthening primary care provision over GP-led commissioning.

“The US have made very good progress in getting their doctors to focus much more on the quality of what they do, rather than just getting paid for treating as many people as they can through a voluntary alternative contract,” Professor Ham told MiP.

“We think their work is very relevant to what is happening over here.”

He said it would be “well worth our while” to offer “something similar” in the UK.

“If we can use the contractual levers we have around primary care to offer another [contract] option that will enable GPs to lead the drive to more integrated, quality-focused care, then there is a real attraction for us in exploring that option, Professor Ham told MiP.

Dr David Jenner, GMS2 and Practice Based Commissioning Leadat the NHS Alliance, told MiP while Professor Ham’s proposal could be a policy idea for the future, the “widespread disengagment” of GPs will mean there will be no changes to the GP contract in this Parliament.

“GPs will see any changes made to the contract as a risk and they will be placed under heavy scrutiny,” he said.

“The government are already battling with GPs over the health reforms and it will not want to add to the tension.”

Professor Ham said it is possible “to get around” this tension by offering the contract on a voluntary basis.

“You don’t get into a very difficult set of negotiations with the BMA by saying we want to change your contract, we’re arguing that there is no reason why they have to change but by offering an alternative alongside – doctors can volunteer to sign up,” he said.

“You wouldn’t just have one contract that would perhaps lead to difficult negotiations with the BMA and may not happen in this Parliament.” 

Your comments (terms and conditions apply):

“Not willingly but alternative contracts are devisive-if voluntary or not and those left on old contracts can be left picking up the disadvantaged disengaged or less financially atractive in the new contract the new contracts are invaribly favourably slanted and draw finances from the older system producing 2 tiers replay the old fund holding exercise” – CMP, Herts