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2014 changes to the GP contract

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The GP contract has been re-negotiated with some changes by the British Medical Council (BMA) and NHS England, which will come into effect from April 2014.

The Quality Outcomes Framework (QOF) will be reduced by 341 points; 238 will be transferred to core funding and 103 to enhanced services.

Dr Richard Vautrey, deputy chair of the BMA's GP committee, said that the removal of QOF points would free up more time for practice nurses. 'For example, offering patients annual blood tests will be removed, as many patients don't need them. It will be less important to give hypertension patients information about exercise and there will no longer be a need to ask men with diabetes if they have erectile dysfunction. We are moving away from box-ticking and this means that practice nurses will have a larger degree of individuality and will be able to utilise all of their skills.'

The contract changes announced included the introduction of a named clinician for the 100,000 most vulnerable and frail patients over 75. A further four million people will be identified and given a named clinician (News Focus, p11). While a GP will oversee the care of each patient, they will still receive care from the whole practice team, said Dr Vautrey.

Jenny Aston, an advanced nurse practitioner and chair of the RCGP general practice foundation nursing group said: 'It doesn't necessarily need to be a GP who could be a named clinician for the over 75 patient group. Instead it could be a senior nurse or an advanced nurse practitioner that oversees their care.'

There will also be a number of IT changes to practices across the country. Patients will be able to access their own records, book appointments and order repeat prescriptions online. While acknowledging that these developments addressed convenience and practice workloads, Ms Aston highlighted the pitfalls of increased reliance on IT. 'Even though most of these changes are happening already, they may prejudice against those who are not that computer savvy,' she said.

To find out more about the changes to the GP contract visit: http://bma.org.uk/news-views-analysis/general-practice-contract

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