The annual changes and updates to the GP contract are always one of the most impactful announcements of the year, and the 2014/15 contractual arrangements are no exception.
The forthcoming changes to general practice could represent a significant cultural change for British GP professionals, defining new priorities and responsibilities for doctors, while evolving their relationship with patients, managers and other professionals in various ways.
The scope and variety of these changes create a number of potential implications for GPs, who will need to educate themselves on the terms of the new contract and change their working practices accordingly.
New priorities and goals
Agreed and published by the British Medical Association (BMA) and NHS England, under direction from the Department of Health, the main aim of the new contract is to improve the standard and transparency of care provision, while also ensuring that patient needs are met in a more adaptable and forward-thinking way.
Perhaps the most significant change is the prioritisation of personalised care. Aiming to introduce an old-fashioned family doctor model, the contract will task GPs with overseeing bespoke, tailored healthcare plans integrating all services.
This means they will offer patients same-day telephone consultations and coordinate care provision with paramedics, A&E doctors and care homes, while also assessing the condition of elderly patients discharged from A&E, reviewing emergency admissions from care homes, and monitoring and reporting on the quality of out-of-hours care.
It will ensure that millions of elderly people have a dedicated GP personally accountable for their care 24/7, ensuring any long-term conditions are managed effectively in a community setting, which should in turn help to reduce the number of unnecessary hospital admissions.
Meanwhile, efforts will be made to reduce administrative burdens upon doctors by scrapping tick box targets and reducing the scope of the Quality Outcomes Framework by more than one-third, ensuring more time and resources can be spent on patient care.
Quality of care will also be enhanced by a new, more transparent inspection and assessment regime for medical professionals, while patients will be able to choose from a wide variety of practices, regardless of their geographical location.
Finally, automatic pay rises for older doctors will be phased out, as part of the government's drive to get rid of progression pay across the public sector. They will remain in place for the next six years for those currently receiving them.
Reactions from the industry
The BMA, which helped to put together the new contract, has responded positively to the announcement, with GP committee chair Dr Chaand Nagpaul suggesting it will help to reverse the "unnecessary targets and excessive paperwork" introduced by last year's contract.
"This will not only free up GPs to spend more time focusing on treating patients, but will also mean that valuable resources will be reinvested in general practice to improve frontline care," he said.
Meanwhile, the Royal College of GPs agreed that working conditions will be better for doctors when the new contract comes into effect, with college chair Dr Clare Gerada noting that a reduction in paperwork and red tape is something for which the organisation has been calling for three years.
"It will help us to get back to our real job of providing care where it is most needed, rather than more box-ticking," she said.
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