09 May 2008
A new set of financial levers is needed to persuade GP practices to tackle health inequalities and improve service quality, the NHS Confederation said this week.
The recent renegotiation of the general medical services contract (which covers most GPs) focused on extending opening times. However, improving general practice does not begin and end with opening hours, the confederation warns in a briefing paper.
Access all areas says that millions of people have undiagnosed conditions or are unable to access the services they need. Existing payment systems are at least partly to blame, the paper says.
It calls for the abolition of the GP minimum practice income guarantee to remove barriers to tackling health inequalities. The MPIG was introduced in 2003, when the GP contract was revised, to ensure practices did not lose income under the new contract. However, about 95% of GP practices still receive payments under the MPIG at a cost of around £600m a year. GPs in deprived areas tend to receive less than those in more affluent ones.
The MPIG gives GPs no incentive to extend their patient lists because they would always be paid a minimum amount, the paper says. And PCTs were bound to fund a minimum level of service via the scheme, even if they brought in private primary care providers to improve or extend services.
David Stout, director of the confederation's Primary Care Trust Network, said the NHS had to consider access in the widest sense.
'It would be short-sighted to focus solely on extended hours when there are many wider issues in making sure patients get the high quality of care they need. It is important to ensure resources get to the practices that need them most,' he added.
The confederation paper was published as NHS London announced this week that 51% of patients backed plans to move GP practices into polyclinics. Health Secretary Alan Johnson announced that 12 new GP practices would be built in deprived areas across the country. Each will receive £1.1m by 2010/11 as part of the Department of Health's £250m access fund, which aims to build 100 new surgeries in the most deprived areas.
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