NHS Employers and the BMA announce changes to the GP contract for 2014/15

GP taking blood pressure

15 / 11 / 2013 Midnight

Major changes to the GP contract in England have been announced today (15 November 2013) which will allow GPs to spend more time with their patients and for more people to be cared for at home and help reduce unplanned emergency admissions.

The changes, most of which will come into force on 1 April 2014, will see a reduction of over a third in the size of the quality and outcomes framework (QOF).  

Reducing the number of indicators from QOF will allow GPs and practice staff more time to focus on the needs of individual patients, avoid unnecessary annual recall and testing of patients and reduce bureaucracy. GPs will use their professional judgement and continue to treat patients in accordance with best practice guidelines.

There are also plans for a more proactive approach with the introduction of a new scheme to help put in place more support mechanisms to help avoid unplanned patient admissions, especially for vulnerable and older people.

The agreement follows months of negotiation between the British Medical Association's General practitioners Committee (GPC) and the NHS Employers organisation, on behalf of NHS England. 

The changes include:
  • An introduction of a new "enhanced service" for patients with complex health needs to avoid them being unnecessarily admitted to hospital or A&E. This will involve a telephone service line where providers can ring GPs to decide whether or not the patient needs to be admitted.
  • Reducing the size of the quality and outcome framework - with 238 QOF points (circa £290m) being made part of the core GP funding. A further 100 points (circa £120m) will fund part of the enhanced service to help prevent patients being inappropriately admitted to hospital.
  • That every person aged 75 and over will be assigned a named accountable GP, who will ensure that patients receive co-ordinated care. 
  • A commitment to monitor the quality of out-of-hours GP services when used by their patients.
  • The introduction of the Friends and Family test from December 2014 asking patients how likely they are to recommend a GP practice. 
  • The introduction of new IT systems including the ability for patients to book appointments online and access their own records.
Stephen Golledge, lead negotiator for the NHS Employers organisation, said: "We are pleased to have reached agreement and believe that the changes will deliver improved care for patients.

"Giving GPs more time to spend with their patients by reducing bureaucracy will allow them to focus on providing the most appropriate care for their patients. Also, by taking a much more proactive approach to patient care, the changes in the contract are designed to ensure patients with  complex needs  receive care as close to home as possible and are only admitted to hospital when clinically necessary.

"In the current economic climate, this is a good deal for patients, GPs and commissioners." 

Dr Chaand Nagpaul, Chair of the BMA’s General Practitioners Committee, said: “We have listened to the concerns of GPs who have been telling us that targets and box ticking were getting in the way of caring for their patients. It is therefore encouraging that we have reached an agreement that will free GPs from time consuming bureaucracy so that they can spend more time treating their patients. 

"This agreement has the potential to be good for patients and lessen the severe pressure that many GPs are facing”. 

Notes to Editors

The Quality and Outcomes Framework (QOF) is a voluntary scheme that provides funding to support aspiration to and achievement of a range of quality standards, by rewarding practices for the volume and quality of care delivered to their patients. Practices score points according to their levels of achievement and payments are calculated on the points the practices achieve.  

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