General practitioners should give up their independent contractor status and become NHS employees, an Imperial researcher has suggested.

Professor Azeem Majeed, Head of the Department of Primary Care & Public Health at Imperial College London considers this radical alternative method of primary care funding in an editorial published today in the Journal of the Royal Society of Medicine.

Professor Majeed, who also works as a part-time GP in South London, suggests that the funding of primary care should also be modified in favour of methods that link workload more closely to funding.

Currently, GPs are paid according to capitation, meaning how many people are enrolled to them, regardless of how many people seek care. In the last few years GPs have seen a dramatic transformation in their circumstances with reduced funding and higher clinical and administrative workload.

Professor Azeem Majeed

When GPs are unable to cope with their workload, he says, pressure will increase on other parts of the NHS such as emergency departments, and affect access to primary care services and on how well GPs can manage patients with complex health needs.

If GPs gave up their independent contractor status, they could become NHS employees under similar employment terms to doctors working in hospitals. This could, says Professor Majeed, allow GPs and their staff to be employed on national NHS terms of service and overcome the divide between self-employed GP principals and salaried GPs.

Other options considered by Professor Majeed include the incorporation of tariff-based methods of funding in place of or in addition to capitation payments; the establishment of ‘super-partnerships’ involving the merger of general practices to allow the formation of larger primary care organisations; or greater collaboration between general practices via the formation of general practice networks or federations.

Based on a news release from the Royal Society of Medicine.

Reference

A. Majeed ‘General practice in the United Kingdom: meeting the challenges of the early 21st century’ Journal of the Royal Society of Medicine Friday 20 September 2013 DOI: 10.1177/0141076813504326