Giving millions of elderly people a dedicated GP personally accountable for their care around the clock will bring back the era of the old-fashioned family doctor, Health Secretary Jeremy Hunt announced today.
Under changes to their contract with the NHS, GPs will ensure the four million patients aged 75 or over will get all the treatment they need for physical and mental conditions.
Other key changes introduce more transparency over practices’ earnings and performance, greater patient choice and fairer pay.
The new contract for 2014/15 was agreed between the British Medical Association’s General Practice Committee and NHS England, directed by the Department of Health.
GPs will oversee personalised care plans integrating all services, so the frail and elderly are better cared for in the community, reducing hospital admissions.
Out of five million emergency admissions last year, one third were people over 75, and more than one million could have been avoided.
GPs’ new responsibilities will include:
- offering patients same-day telephone consultations;
- offering paramedics, A&E doctors and care homes a dedicated telephone line so they can advise on treatment;
- coordinating care for elderly patients discharged from A&E;
- regularly reviewing emergency admissions from care homes to avoid unnecessary call-outs in future; and
- monitoring and reporting on the quality of out-of-hours care.
It is hoped this service will eventually be offered to millions more vulnerable people with long-term conditions that need more support.
Secretary of State for Health, Jeremy Hunt said:
“The 2004 GP contract broke the personal link between GP and patient. It piled target after target on doctors, took away their responsibility for out-of-hours care and put huge pressure on our A&E departments. This government has a plan to sort this out and today’s announcement of a new GP contract is a vital step.
“We are bringing back named GPs for the vulnerable elderly. This means proper family doctors, able to focus on giving elderly people the care they need and prevent unnecessary trips to hospital. Rigorous new inspections of GP surgeries will mean every local person will know whether they are getting the care they deserve.
“This is about fixing the long-term pressures on our A&E services, empowering hard-working doctors and improving care for those with the greatest need.”
Chair of the Council of the Royal College of General Practitioners, Dr Clare Gerada said:
“This is welcome news for patients and for GPs as it will help us to get back to our real job of providing care where it is most needed, rather than more box-ticking.
“It is not the remit of the College to get involved in contractual negotiations, but we have been calling for this for three years and are pleased that the Government and the BMA have been able to reach a solution that is workable for doctors and, most importantly, focuses our time on improving the care that our patients want and deserve.”
Tick box targets
To free up more time for doctors to devote more time to patients, burdensome GP tick box targets will be scrapped.
There will be a reduction of more than a third of the Quality Outcomes Framework (QOF), which dictates how GPs should test and treat patients for specific conditions, such as diabetes and heart disease.
Getting rid of this rigid, one-size-fits-all approach will improve patient care as doctors will be trusted to use their professional judgement and make decisions based on what each individual patient specifically needs, taking all their conditions into account.
The money GPs currently earn from meeting these targets will instead be pumped into overall budgets and enhanced services.
GP practices will publish results of a rigorous new inspection regime in surgery waiting rooms.
The Care Quality Commission’s chief inspector of general practice, Steve Field, will develop an easy-to-understand ratings system based on four categories: Outstanding, Good, Requires improvement, and Inadequate.
GPs will also look at how to publish details of their earnings.
Practices will also be freer to recruit patients from outside traditional boundaries, giving patients greater choice, informed with more information.
Patients will also be given a clearer voice to feed back their views and experiences with the introduction of the Friends and Family Test to general practice.
Other improvements to GP patient services will include making it compulsory for surgeries to offer appointments and repeat prescriptions online.
Automatic pay rises for older doctors will also be phased out as part of the government’s drive to get rid of progression pay across the public sector.
The £80 million cost of seniority payments, which are tied to length of service and average £6,000, will be re-invested in general funding for practices, based on the amount and types of patients they serve.
NHS Employers negotiated with the GPC on behalf of NHS England and more information about the contract is available here.