The new GP contract has cost more than expected although there are early signs of benefits for some patients

The new contract for GP practices should have been better planned and will take time to improve care for patients. However, there is evidence of improvement in the care of some patients.

An Audit Scotland report published today, Review of the new General Medical Services contract, says that the new GP practice contract, introduced in April 2004, has brought some benefits for patients, GPs and the wider NHS. These include better monitoring of people with certain long-term conditions such as diabetes, increased income for GP practices, and flexibility for NHS boards to plan healthcare based on the needs of the local population.

In the first three years of the new contract, general medical services cost £160 million more than was allocated to NHS boards to pay for these services. The majority of the additional costs are due to higher than expected costs of implementing an incentive payment system for the quality of care, and ensuring that no practice is financially disadvantaged by the new contract.

The Auditor General for Scotland, Robert Black, said: "The new contract for GP practices is an opportunity to improve both patient care and the working lives of GPs, and give the NHS greater flexibility. 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. 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.

The report says the new contract has the potential to develop care for patients. In particular it gives NHS boards greater flexibility to move services from hospital to the community and to deliver services tailored to specific local needs, such as drugs misuse services and healthcare for homeless people.

The report also highlights a lack of basic management information about general practice in Scotland. The NHS does not know how many of Scotlandís GPs work full or part time. There is also a lack of comprehensive data on staff numbers, workload and activity in practices. This makes it difficult for the NHS to plan effectively.