GPs must continue to provide some non-core servicesNHS trusts could save (pounds sterling)150m by improving supplies managementLevel of provision for long term care must be definedGMC advises doctors on intimate examinationsGMC wants to improve reporting of conduct casesOpen information is a closed bookBMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7067.1266 (Published 16 November 1996) Cite this as: BMJ 1996;313:1266
- Linda Beecham
GPs must continue to provide some non-core services
General practitioners must continue to provide some non-core services until there have been national negotiations to change their terms and conditions of service. Failure to do so would put doctors in breach of their terms of service.
The General Medical Services Committee's document, Core Services: Taking the Initiative, which was sent out to all general practitioners this week, identifies the services which should be provided by every doctor or practice (26 October, p1032). Among the non-core services there are some which general practitioners are still obliged to provide under their terms of service. The GMSC hopes to negotiate with the government to remove this obligation so that in the future these services may be contracted for separately and paid for outside intended average net remuneration.
They hope to make the following changes: removing the requirement to provide certificates for social security purposes; allowing a charge for all travel immunisations; abolishing the requirement to offer annual health checks to the over 75s; and removing the training of general practitioner registrars, intrapartum care, minor surgery, child health surveillance, and dispensing (other than of personally administered items) from core services and average intended net remuneration.
The medical care of highly dependent patients living in the community, often in nursing or residential homes, is another non-core service. The chairman of the GMSC, Dr Ian Bogle, said: “In the past these patients would have been in long stay hospital beds and so would have had resident doctors and specialised nursing care …