Letters Paying GPs for service

Scotland’s projected changes to general practice

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5685 (Published 27 October 2015) Cite this as: BMJ 2015;351:h5685
  1. Miles B Mack, chair1
  1. 1Royal College of General Practitioners Scotland, Edinburgh EH2 1JX, UK
  1. scottishc{at}rcgp.org.uk

McCartney’s article continues a dialogue contributed to by my predecessor John Gillies.1 2

In Scotland we are close to moving away from the tick box world described. Colleagues from the Scottish General Practice Committee are in negotiations on a contract to replace the Quality and Outcomes Framework (QOF) with new proposals that incorporate the Royal College of General Practitioners’ (RCGP) vision of a “peer-led, values driven” model of quality, leadership, and governance.3 The cabinet secretary for health has recently announced the phasing out of QOF and has endorsed the RCGP approach.4 Our vision is to create GP “clusters” that will be responsible for quality planning for their locality, be given resources to undertake quality improvement, and will demonstrate the quality assurance needed of GPs in a modern health and social care system, as described in the joint RCGP and Health Care Improvement Scotland document.5

We have a long way to go and we do not underestimate the difficulty in delivering the changes needed. The obvious barrier is the present climate, in which general practice is being resourced at record low levels and workload and workforce are ever increasing challenges.6 Putting patients and locality at the centre and rebuilding professionalism will be a key to reversing negative views about general practice. This approach will also enable the delivery of integrated and community delivered care, as described in the Scottish Government “2020 Vision.”7


Cite this as: BMJ 2015;351:h5685


  • Competing interests: None declared.


View Abstract

Sign in

Log in through your institution