Scottish GPs to be polled on new contract proposals

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Family doctors across Scotland will be consulted on new ways of working and funding after the BMA and Scottish Government reached an agreement over a new GP contract.

The changes to the way doctors are funded seek to address rapidly increasing workloads and vacancies in the profession, which has led to long waiting times for appointments.

The proposed reform would be the biggest change to primary care services in over a decade, and would see GPs lead community healthcare teams including nurses, physiotherapists and pharmacists.

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The deal also aims to make general practice more attractive by offering a basic guaranteed income and interest-free loans for practice premises, reducing the burden of responsibility for the buildings.

The new funding formula will reflect levels of deprivation and numbers of older patients.

GPs will be polled on the new deal between 7 December 2017 and 4 January 2018, with a letter going to every practice in Scotland with details of the deal this month.

Negotiations over the contract have been lengthy. The Scottish Government pledged to replace the Quality and Outcomes Framework (QOF), which paid doctors based on an itemised list of services, in 2015.

Health Secretary Shona Robison said: “GPs tell us they want to spend more time with patients with undiagnosed illness and less time on bureaucracy, while patients say they want better access to GPs when they really need them.

“We have listened and, I believe, we have achieved that balance.”

Dr Alan McDevitt, chair of the BMA’s Scottish GP committee, said the aim had been to make general practice more sustainable.

“This contract offers solutions to the pressures faced by general practice,” he said.

“By expanding the primary care team and working with integration authorities to improve patient access to services delivered by other professionals, such as, practice nurses, pharmacists and physiotherapists, GPs can have more time to concentrate on being GPs.

“The additional funding attached to this contract is a significant investment and demonstrates the value placed on the role of general practice in the NHS in Scotland.  The new contract offers income stability and reduced business risk to individuals.”

However, retired GP Dr Euan Paterson told Holyrood in September the move to multidisciplinary teams will mean GPs will have fewer chances to build up a relationship with patients.

“General practice is being pushed into its margins leaving its core unfathomed by both critics and spokesmen,” he said.

“Not enough people value the core of this to cherish it.”

Earlier this year the Royal College of GPs in Scotland insisted doctors must remain the first point of contact, while recommending patients be consulted in service redesign.

Its ‘Core Values’ report, which the body said it would use to evaluate any new contract, warned: “Patient feedback and participation should be central to the development of any new model.”

The outcome of the poll will be discussed at the meeting of the BMA’s Scottish GP committee on 18 January 2018, where a decision will be taken on whether to accept the new contract.