Nurses have been formally invited to consult on changes to the GMS Contract 2013/14, outlined by health secretary Jeremy Hunt.
The revisions would see practices rewarded for earlier diagnosis and better care of dementia patients and putting a sharper focus on improving the lives of patients with long-term conditions.
For the first time, the RCN has been invited by the DH to put forward a response to the proposal and its director of policy Howard Catton has called on primary care and community nurses to contribute.
He said: 'I don't recall that we have had a formal request such as this before and I think it is a recognition that nurses have a big contribution to make in the areas of risk profiling, long-term conditions, preventive work and specialist nursing.
'We think about a quarter of RCN members work outside of acute care and this number is growing. We haven't compiled our response yet but if there are nurses in primary and community care with a view, we would urge them to contact us.'
The main changes proposed in the DH consultation comprise the phasing out of the MPIG over seven years; any overall increase in the value of GP contract payments, which will be decided following recommendations from the Doctors and Dentists Pay Review Body in February, being distributed in a way that gives some increase to all GP practices but targeted towards those with less current funding per patient; and all NICE recommendations for new and improved indicators to the QOF being implemented in full.
Under the revised contract QOF reward thresholds would be increased and organisational QOF payments will be discontinued. It is hoped this will release £164 million which can be used to help fund improvements in patient care through the implementation of all the NICE recommended changes and the commissioning of extra services from GP practices.
The extra services to be commissioned from GP practices would cover improving the assessment of people with dementia; improving care management for frail older people and other high risk patients at risk of unplanned hospital admissions; using technology to help monitor the health of people with long term conditions and improving online access to services.
The DH is also proposing investment of up to £10 million annually in GP practices for two vaccination programmes for rotavirus and shingles.
Mr Hunt said: 'Getting patients an earlier diagnosis of dementia and supporting those with long term conditions are my main priorities. We have listened to, responded to and fully considered alternative proposals put forward by the British Medical Association's General Practitioners Committee. In the absence of an agreed settlement, it is reasonable to consult on the proposed changes needed to make sure improvements in patient care will follow.'
However, chair of the GP's Committee Dr Laurence Buckman warned the proposed contract changes would increase practices' workload, while reducing core funding. ‘The government's proposals may sound attractive on the face of it and some of their suggestions are good, however they have not fully considered the overall impact on practices of all these changes being implemented together,' he said.
‘This could make it difficult for some practices to maintain the level of care they currently offer, let alone increase their capacity to meet the demands of these new proposals.'
He said the BMA planned to ‘closely analyse' the details of the proposals and remained open to ‘real dialogue' with the government.
The BMA's General Practitioners Committee and other primary care organisations have until the 26 February 2013 to respond to the government's proposals.A consultation on the changes was launched after a negotiated settlement could not be agreed following a series of discussions between the British Medical Association and NHS Employers.