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GP contracts in £160m overspend GP contracts in £160m overspend
(1 day later)
The new GP contract, which allowed most doctors to stop doing out of hours calls, cost £160m more than had been allocated in its first three years.The new GP contract, which allowed most doctors to stop doing out of hours calls, cost £160m more than had been allocated in its first three years.
An Audit Scotland report into the contracts found that the scheme should have been better planned.An Audit Scotland report into the contracts found that the scheme should have been better planned.
But it added that there were early signs that patients benefitted in areas like monitoring and flexibility.But it added that there were early signs that patients benefitted in areas like monitoring and flexibility.
New GPs contracts were brought in four years ago and have seen the average GP's income rise 38% in two years.New GPs contracts were brought in four years ago and have seen the average GP's income rise 38% in two years.
Auditor General for Scotland Robert Black said: "There are early signs that the contract has addressed GP concerns about pay and work life balance, and has improved services for some patients.Auditor General for Scotland Robert Black said: "There are early signs that the contract has addressed GP concerns about pay and work life balance, and has improved services for some patients.
"However, there was insufficient planning for implementing this contract, partly due to a lack of available data on primary care and an underestimation of the costs of the contract.""However, there was insufficient planning for implementing this contract, partly due to a lack of available data on primary care and an underestimation of the costs of the contract."
He added: "The challenge for the Scottish Government, the NHS and GPs is to build on the early signs of improvement and to deliver better outcomes for patients."He added: "The challenge for the Scottish Government, the NHS and GPs is to build on the early signs of improvement and to deliver better outcomes for patients."
Without better co-operation between government and GPs, these benefits may be short-lived Dr Dean Marshall BMAWithout better co-operation between government and GPs, these benefits may be short-lived Dr Dean Marshall BMA
The new contract was introduced because the previous one was seen as "no longer fit for purpose".The new contract was introduced because the previous one was seen as "no longer fit for purpose".
It was designed to address concerns over workloads and payments, look at recruitment problems and deliver services closer to patients' homes.It was designed to address concerns over workloads and payments, look at recruitment problems and deliver services closer to patients' homes.
GPs were also to be paid more for targeting particular conditions such as diabetes.GPs were also to be paid more for targeting particular conditions such as diabetes.
The auditor general's report pointed to a "lack of basic management data" on general practice.The auditor general's report pointed to a "lack of basic management data" on general practice.
The NHS does not know how many GPs work full-time or part-time, with a lack of data on staff numbers and workload, making it "difficult for the NHS to plan effectively".The NHS does not know how many GPs work full-time or part-time, with a lack of data on staff numbers and workload, making it "difficult for the NHS to plan effectively".
Eleven of Scotland's 14 health boards said patient care has improved as a result of the new contract, but the report says more work is needed to demonstrate improvements in access and health. Eleven of Scotland's 14 health boards said patient care had improved as a result of the new contract, but the report says more work is needed to demonstrate improvements in access and health.
The Scottish Government welcomed the fact that the report looked at "benefits to patients, GPs and the wider NHS".
But Health Secretary Nicola Sturgeon acknowledged that it also highlighted a "substantial underestimate of resources" and "concerns over the provision of basic management information about general practice in Scotland".
She added: "We must now build on the improvements for patients the report identifies and work to address the lack of information on GP practices the report reveals."
Adapted quicklyAdapted quickly
Dr Dean Marshall, chairman of the BMA's Scottish General Practitioners Committee, said GPs had adapted quickly to the new ways of working.Dr Dean Marshall, chairman of the BMA's Scottish General Practitioners Committee, said GPs had adapted quickly to the new ways of working.
"Already patients are reaping the benefits," he said. "But without better co-operation between government and GPs, these benefits may be short-lived."Already patients are reaping the benefits," he said. "But without better co-operation between government and GPs, these benefits may be short-lived.
"In the last three years, practices have seen cuts in their core funding which adversely affects the services they can provide to patients.""In the last three years, practices have seen cuts in their core funding which adversely affects the services they can provide to patients."
The Royal College of Nursing in Scotland said it was concerned about lack of information on the work carried out by practice nurses and other staff in GP practices across Scotland.The Royal College of Nursing in Scotland said it was concerned about lack of information on the work carried out by practice nurses and other staff in GP practices across Scotland.
Director Theresa Fyffe said: "We urge the Scottish Government and health boards to ensure that GPs provide data on all the staff they employ in order to allow robust workforce planning to take place and to ensure that the contribution of all staff within GP practices, including practice nurses, are appropriately recognised and rewarded."Director Theresa Fyffe said: "We urge the Scottish Government and health boards to ensure that GPs provide data on all the staff they employ in order to allow robust workforce planning to take place and to ensure that the contribution of all staff within GP practices, including practice nurses, are appropriately recognised and rewarded."
The Scottish Conservatives said while there were "some cost issues to carefully examine, family doctors across Scotland have risen to the challenge of delivering more health care nearer patients homes".The Scottish Conservatives said while there were "some cost issues to carefully examine, family doctors across Scotland have risen to the challenge of delivering more health care nearer patients homes".