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Last Updated: Friday, 20 June, 2003, 12:11 GMT 13:11 UK
GP Contract: Impact on patients
GPs have voted overwhelmingly in favour of a new NHS contract.

BBC News Online examines how the changes will affect patients.

Will GP surgeries open longer during the day?

GP surgeries will not have to be open outside the hours of 0800 to 1830, Monday to Friday, under the new contract. Some GPs, like now, will continue to provide extra clinics in the early morning, evenings and weekends. However, they will not be required to do so.

Will patients be able to see their GP more quickly?

In theory, patients will be able to see their GP more quickly. The new contract includes substantial extra funds for primary care. This money will be allocated to practices and is expected to be used to employ additional staff, including nurses.

The thinking behind this is that it will enable GPs to refer patients with less urgent medical conditions to other practice staff. In turn, this will hopefully enable them to spend more time with those patients who are most in need.

Can patients see any GP they want?

Yes, patients will still be able to specify which GP they wish to see.

However, new rules will mean that GPs will also be able to turn away patients if they feel they are treating enough people already.

Many GPs have already closed their lists to new patients. However, primary care organisations can force them to take on additional people. Under the new contract, practices will be able to appeal against such a decision making it easier for practices to control their list size.

Will GPs stop offering some services?

Under the terms of the new contract, some GPs may be able to opt out of providing medical services, such as cervical screening, contraception or immunisation clinics.

However, this will only be allowed in certain conditions - if the practice is particularly overstretched, for example.

More likely, GPs may actually start to offer additional services to patients. For instance, some doctors with an interest in specific conditions like diabetes may offer clinics that are normally only available in hospitals. GPs will be able to apply for extra cash to help them set up these clinics.

Will the new contract affect the quality of care patients receive?

GPs, NHS managers and even government ministers hope the proposed contract affects the quality of care given to patients - in a good way, obviously.

A large proportion of a practice's income and, therefore, a GP's salary will in future be linked to the quality of care they provide.

GPs will be assessed on a wide variety of measures. They will be given extra money if they stop patients smoking, for instance, or if more of the children attending the practice are immunised against certain diseases.

Will patients have access to their GP when the surgery is closed?

No. One of the most controversial aspects of the new contract is that GPs will no longer be legally required to provide 24-hour care for patients.

In years gone by, patients were able to phone up their GP at any hour of the day or night if they felt unwell. In recent years, GPs clubbed together to form out-of-hours cooperatives to share this burden.

Under the new deal, GPs can transfer responsibility for providing out-of-hours care to primary care organisations. They are likely to employ their own doctors to specifically provide care out-of-hours. Nurses, paramedics and other health professionals could play a greater role in providing care to patients when surgeries are closed.

Will patients get a say in any of these changes?

Patients will not be asked if they agree to or support any of these proposed changes.

However, some practices may choose to ask patients to fill out an annual survey on the performance of the practice. The practice will be assessed and potentially rewarded financially if the concerns of patients are addressed.

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