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Ditch quality premium, say majority of GPs

BMA survey shows 75% of respondents disagree with plan to link practice income to performance

Caroline White

Monday, 24 October 2011

Three out of four GPs in England don’t agree with the proposal outlined in the Health and Social Care Bill to link practice income to the performance of the commissioning group. 

The findings feature in the results of a survey carried out by the BMA to gauge the views and concerns of family doctors on the major issues facing general practice. 

The survey, which was sent to every GP in England, was carried out in April this year and covered issues ranging from workload and morale to the proposals in the Health and Social Care Bill. Interim figures were published in June 2011 based on the first 10,000 responses.

The response rate was 40% (18,757 out of 46,700), making it the most significant survey of GP opinion in recent years, says the BMA.

The results showed that nine out of 10 GPs (88%) say the intensity of their consultations has increased over the past five years, while 84% say the complexity of their consultations has increased.

Three out of four GPs in England do not agree with the proposal in the Health and Social Care Bill to link practice income to the performance of their commissioning group. 

In its response to the NHS Listening Exercise, the government indicated that the Bill would be amended to clarify the link between the premium and commissioner performance. Separate regulations will define the rules around whether a quality premium should be paid, and how it can be spent.

But seven out of 10 GPs are also concerned about conflicts of interest inherent in the reforms, both for the impact they could have on the doctor-patient relationship (68%) and because of their role as both the commissioners and providers of care (69%).
A further 85% do not believe that practice boundaries should be abolished.

Commenting on the survey findings, Dr Laurence Buckman, Chairman of the BMA’s GPs Committee, said: “The huge response rate shows how strongly GPs feel about the topics in question, particularly when it comes to the changes being made to the health service in England.  

GPs do not want the trust patients put in them to be damaged by these reforms, yet this is exactly what they fear will happen. The government must take heed and further revise its plans for the quality premium in particular, to avoid any potential damage to the doctor-patient relationship.”

Dr Buckman said that general practice had undergone huge change since the last equivalent survey in 2007.

“Much of the work we do now, such as looking after people with diabetes, used to be done in hospital and even though it’s work we want to do because of the clear benefit to patients, it has made it harder to fit a consultation into a ten minute time slot and it can make it more difficult to deal with surges in demand,” he said.

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