The government is proposing to change the GP contract to stop financial payments for organisational tasks and reward practices for giving patients access to online services.

The Department of Health released a statement this morning saying it has sent its proposals to the British Medical Association for consideration, but warned that it may impose them with or without the union’s support.

The two organisations have been in talks for five months about the new contract and the announcement appears to have surprised the BMA, which has called for the government to return to the negotiating table.

The DH statement says the proposals put to the BMA include possible new quality improvement schemes for diagnosis and care of people with dementia, care for the most frail or seriously ill patients, patient access to online services and support to help people with long term conditions better monitor their own health.

The proposals would stop additional rewards for organisational tasks like good record-keeping, which the DH says should be part of any good health organisation, and make Quality and Outcomes Framework payments reflect advice from NICE.

Health secretary Jeremy Hunt said the changes are about putting patients first.

“The GP contract needs to change so that it further improves care for patients,” he said.

“Our population is living longer and an increasing number of people have long term conditions. We want to drive up standards for all and want the contract to reflect the most up-to-date expert guidance and excellent standards of care.

“We want the BMA to work with us on making this happen, but will not back away from making changes that will deliver better care for patients,” he added.

If the government is unable to reach agreement with the BMA, it will move to a period of "formal consultation."

Responding to the announcement, Dr Laurence Buckman, chair of the BMA’s GP committee, said there are: “serious question marks over whether some of the intended changes are based on sound clinical evidence or are practical or feasible.”

“The implications of the government’s new proposals for general practice are likely to be huge, and we will be examining the consequences of this threatened imposition so that we can fully inform the profession and public as soon as possible,” he said.

“GPs will be stunned and angered that the government is disregarding five months of detailed negotiations between the BMA and NHS Employers which was in its final stages just a couple of weeks ago.

"The government must urgently rethink its approach and return to our negotiated settlement that was so close to being concluded.”

Dr Buckman said many practices are already stretched to breaking point and the government appears to be ignoring this situation.

“For all practices, the changes will place an enormous strain on GPs at a time when they are struggling under the weight of a wholesale NHS reorganisation, especially the implementation of clinical commissioning groups,” he added.