The Welsh Government has agreed changes to the GP contract for 2014/15 with the General Practitioners Committee (Wales).
Key changes to the contract include a reduction of almost a third in the number of points in the Quality Outcomes Framework and starting in 2015/16, the redistribution of Minimum Practice Income Guarantee (MPIG) funding on a formula weighed needs basis over a seven year period.
Other changes include:
– Strengthening the delivery of local health care through GP practices working closely in small groups or clusters located in the Local Health Board’s area of operation to improve the co-ordination of care, improve the integration of health and social care and improve collaborative working with local communities and networks to reduce inequalities in health.
– Addressing accident and emergency admissions and unscheduled care admissions through a requirement for practices to participate in three national care pathways (evidence-based practice for a specific group of patients) covering the early detection of cancer, end of life care and the frail elderly. The government believes these national care pathways will have a high impact on reducing emergency admissions and unscheduled care admissions.
Welsh Health Minister Mark Drakeford said: “The changes we have agreed will remove the treadmill of bureaucracy facing GPs, allowing them to spend more time with their most vulnerable patients, particularly the frail elderly.
“By removing some of the current requirements on GPs, we are both freeing up valuable time and putting more trust in the professional judgement of doctors, allowing them to treat their patients as individuals rather than to satisfy a set of criteria.
“We are also, by changing the funding formula for practices, addressing the inequalities in health which exist between the most and least affluent areas of Wales.
“It makes perfect sense for GP practices to work with each other to provide a wider range of care within geographical areas, which we will see happen more as a result of changes to the contract. It is vital that Local Health Boards continue to work closely and proactively with GP practices to support them in the delivery of the improvements in patient care through these changes to the contract.”
Dr Charlotte Jones, chair of the British Medical Association’s GP Committee in Wales, said: “We believe that these changes will enable practices to have the ability and capacity to better manage demand and the needs of their patients, as well as reducing bureaucracy. We believe these changes will make a significant difference to the challenges that GP practice teams face day to day.
“We understand that practices will be anxious about the MPIG proposals but can assure them that the proposals for Wales have been modelled down to individual practice level as we believe this to be the safest and most pragmatic way forward which should not destabilise practices and I assure you will protect the outlying practices in perpetuity. We urge practices to read the detail of the proposals, await their individual letters and read our further information on this which will be sent via email to all practices within 24 hours.
“GPC Wales recognises the potential value of networks to meet the Welsh Government’s strategic priorities but these can only be effective if LHBs work closely and proactively with practices and support them in ensuring they are successful in delivering improved patient care. The Minister’s guidance to LHBs to this effect is welcomed. The proposal for a three year framework for the locality development service scheme will start this process in a consistent manner across Wales in 2014/15.”
