Audit report says new GP contract has delivered some improvements but does not yet represent value for money
The new contract for GPs must deliver all its potential benefits if it is to represent value for money, according to a new report from the Assembly’s Audit Committee.
The Committee’s Review of the New General Medical Services Contract in Wales, published today (Wednesday January 16), concludes that although the new contract has delivered some benefits, there needs to be a focus on delivering the full potential of the contract, particularly to improve access, outcomes and performance management.
The new contract cost the NHS in Wales £131million in 2005/6 – 44% more than the old contract – but there are concerns that improved access to GPs has not been consistently delivered or monitored.
Improved access to primary care is a key priority for patients. However, the rigour and quality of Local Health Board (LHB) checks on practices to ensure that they are meeting targets is variable. The report recommends that the Welsh Assembly Government should issue guidance on checks and strategies to improve patient access early this year.
The new contract has delivered some improvements. Enhanced services are starting to bring more specialised services closer to patients’ homes and investment in premises is starting to increase. GPs benefit from increased pay (an average of 25% in the first two years of the contract) and reduced working hours. This means that general practice is more attractive, and there are few recruitment and retention problems in Wales.
In addition, patients are benefiting from improved management of many chronic conditions through the Quality and Outcomes Framework (QOF) and this is expected to continue. However, many LHBs are struggling to release savings from secondary care to fund these changes, and the Committee recommends that the Welsh Assembly Government should make it easier for LHBs to transfer resources from secondary care to improve primary and community services.
David Melding AM, Chair of the Audit Committee, said: “The new contract has delivered some benefits for patients in Wales, but more needs to be done to ensure that all the potential benefits are realised, or it will not represent value for money.
“There is inconsistency in contract management across Wales, with some important checks not happening. This is unacceptable. The Committee has made a number of recommendations to the Welsh Assembly Government and I hope these are acted upon so that improvements can continue and patients receive the service deserve.”