Contract for GPs in England “failed to live up to expectations,” say MPs

BMJ 2008; 337 doi: (Published 09 October 2008) Cite this as: BMJ 2008;337:a2025
  1. Zosia Kmietowicz
  1. 1London

    England’s spending watchdog has delivered a damning assessment of the government’s attempts to modernise primary care through the new GPs’ contract, which came into effect in April 2004.

    Costing £1.8bn (€2.3bn; $3.2m) more than predicted in its first three years, says the Public Accounts Committee, the contract fully achieved just one of its objectives: to attract more doctors into general practice. Since March 2003 an additional 4098 GPs have been working in primary care, an increase of 15%.

    But productivity in general practice has fallen by an average of 2.5% a year since the contract was launched, rather than increase by the expected 1.5%. And patients in deprived areas continue to struggle to access GP services, despite this being one of the goals heralded by the BMA as a top priority in its lengthy negotiations with the Department of Health over the new deal for GPs.

    The committee’s report acknowledges that some progress has been made in linking GPs’ pay to performance. It is critical, however, of the quality and outcomes frameworks (QOF) system, developed to measure performance. With targets set too low it was simply too easy for GPs to achieve high scores, resulting in additional unexpected costs for the …

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