No New Clinical Work in GP Contract

The chair of the General Practitioners Committee, Dr Chaand Nagpaul, has stated that the GP contract deal for 2017/18 includes no new clinical work for GPs.

New contractual requirements will see doctors involved in treating the frail elderly, with these duties replacing previous obligations under the scrapped avoiding unplanned admissions DES.

It will now be requisite for GPs to clinically review all patients placed on an over-65 risk register.

An appropriate identification tool must be utilised for this process.

But Nagpaul states that in the whole contract deal “there is no new clinical work for GPs, and there is a reduction in the biggest area of frustration for GPs”, which was the scrapped DES.

Nagpaul instead suggests that the bureaucratic nature of the DES has been overcome by the new deal.

“All you now have to do is a medication review and to ask frail patients about falls. These are the patients that are the most vulnerable in society and all of these patients will have been seen by a GP. The requirement is not asking for a care plan, it is not specifying the detail of what you do. You are able to be a GP providing clinical care. Most of these people are on multiple medications and medication review is part of our normal practise. So there is nothing actually extra to do,” Nagpaul commented.

But NHS Employers has already stated in its guidance on the contracts that failing to carry out reviews could result in breach-of-contract notices.

“Recording such activity and reviews in the patient record is standard practice and as such, we do not anticipate that practices would not meet this contract requirement. Where this may not be the case, there is a standard operating procedure for dealing with breaches of contract,” the organisation notes.

Nagpaul also suggested that the decision and to agree to automatic contractual extraction of data on retired QOF indicators and enhanced services is a natural move.

“This is something that has been done since 2004, when the [new GMS] contract was negotiated. The extractions have been going on now for years, and the majority of practices enable the extractions. We’ve never had any issues around it and we will only be agreeing to clinically appropriate extractions. So we are not introducing something that practices are not doing. The Government wants public health data, that is what their interest is, but it is not a new phenomenon and it is already being done by a majority of practices.”

A full list of this data has been promptly published by NHS Employers.

Yet despite the comments of Nagpaul, many NHS leaders disagree with the terms of the new contract, and there could be considerable haggling to come in the next few months.


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