THE British Medical Association (BMA) and the Scottish Government have signed a joint agreement on the future direction of GP services, and the government has committed to pay stability for GPs up to April 2018 while a full review of pay and expenses can be carried out next year.
The agreement, which was sent to all GPs this morning, sets out the next steps on the redesign of services so that GPs can become clinical leaders of expanded teams of health professionals working in the community.
A letter which accompanied the agreement acknowledged that general practice was facing “unprecedented challenges”, which included: increased workload, increased risk relating to staff and premises, and recruitment and retention.
The Scottish Government and Scottish General Practitioners Committee were committed to working together to meet these challenges and while some changes, such as the removal of QOF, had already taken place, the next steps were to “agree a practical way forward on premises, on workload and sustainability, and support for clusters.”
General practice could not be delivered through the GMS contract alone, a wide range of partners would be needed to transform how primary care services were configured and delivered, which meant significant investment in the primary care workforce and infrastructure.
Current GMS services needed to be reviewed so that, where appropriate, responsibility for those services could be transferred to the wider healthcare system with the aim of meeting patients’ needs and making use of the skills mix in primary care.
Health Secretary Shona Robison said: “This agreement is significant because it is the bedrock of a strong partnership between the Scottish Government and the GP profession. We want to improve and redesign the way health services are provided in the community, but this can only be achieved by working in partnership with profession.
“We are significantly increasing the amount of investment going into primary care – an extra £500 million by the end of this Parliament. However, as we have made consistently clear, we must also reform the way we provide services.
“We are shifting the balance of care away from hospitals and into the community, and GPs have a vital role to play in working with us to make it happen. For our part we will work to improve the attractiveness of general practice as a career, with action on workloads, and steps to create a more sustainable workforce.”
Dr Alan McDevitt, Chairman of the BMA’s Scottish General Practitioners Committee, said: “This important agreement is the result of ongoing negotiations that began last year. In April, we agreed the removal of Quality and Outcomes Framework and have negotiated a number of other measures including new maternity and paternity support; a national performers list; occupational health service for all GPs and practice staff and funding for emergency oxygen.
“Our shared vision for the future of Scottish general practice requires a team approach. It relies on clinical and non-clinical staff working together and to progress this there needs to be discussion that goes beyond the GP contract. We are mindful that this is an ongoing process, that further contractual changes will be necessary and that it will take time to make general practice in Scotland sustainable for the future.
“Following on from the First Minister’s commitment to invest an additional £500 million a year in primary care by 2021/22, we will continue to negotiate how to modernise the contract, improve access to general practice and improve the attractiveness of general practice as a career to ensure that patients continue to receive the care they need.”