Frontline doctors who care for some of the sickest and poorest people in Scotland are the latest group to raise serious concerns about the proposed new contract for general practice.
GPs from the Govan SHIP (social and health integrated partnership) project have released a statement which criticises the new funding formula which they say is heavily weighted in favour of practices who have a higher percentage of affluent elderly patients as opposed to younger deprived people with multiple health problems.
The flagship project – which is now in its third year and is funded by the Scottish Government – has had notable successes, leading to a decrease in emergency, outpatient and GP appointments. It also gives patients access to social workers and help with other issues including housing problems.
Govan SHIP involves 20 GPs working in four practices known as Deep End because of their location in a socially-deprived area dealing with complex and multiple needs patients.
Rural GPs were the first to highlight potential problems with the new GP Workload Formula, brought in by consultants Deloitte working alongside the Scottish Government and BMA Scotland.
The Govan SHIP statement highlights concerns the GPs in the Deep End practices have with the “inherent bias” of the Scottish Workload Allocation Formula (SWAF for the distribution of funds. This, they say, makes them conclude that accepting the new contract in its curent form is “now unacceptable”.
The statement says: “It would require a much larger net investment into GP funding to actually shift the necessary sums from rural affluent/elderly to the urban deprived. There has been little mention of plans to make large investments in the GP funding stream that would be required to fund this.”
Although accepting there are positives to the new proposal such as a minimum income, the Deep End Steering Group believes GPs have been asked to vote on the contract without knowing the full details of the workload formula.
Dr John Montgomery, Chair of the Govan SHIP Project said: “The SHIP is the way that we would like to see general practice go and there are certain aspects in the contract that fit in with what we’ve been trying to do – particularly around integrated care.
“The bit that clearly isn’t working in the formula is where the allocation of funding lies.
“This is something that is based on patient demand and certainly not patient need.
“There is obviously a huge weighting for affluent elderly which is significantly greater than that given to social deprivation.”
GPs are currently being polled on whether to accept the new contract with the results due to be announced early next year.
Chair of BMA Scotland’s GP Committee Dr Alan McDevitt said: “The proposed GP contract will protect the funding of every practice in Scotland while also addressing the current underfunding of the workload associated with greater deprived and elderly populations.
“The workload formula is only one part of the package of support that the proposed contract will bring to general practice that will benefit practices in deprived areas, such as the expansion of link workers.”
A Scottish Government spokesperson said: “The new contract will ensure GPs can spend less time on bureaucracy. If accepted, it will help cut doctors’ workload and make general practice an even more attractive career.”