Health minister Earl Howe has hinted that the government could push ahead with changes to the GP contract even if it cannot get union agreement.
Speaking at a National Association of Primary Care conference this morning, Earl Howe said the contract needed to change to deliver further improvements in care for patients and additional value for money to the NHS.
He said negotiations with the British Medical Association had been going on for a number of months without reaching agreement.
"We are very keen that negotiations should continue we still want to find mutually acceptable solutions,” he said.
However, he added: "We want the BMA to work with us in making this happen but we won’t back away from making changes that will deliver better care for patients."
The Department of Health issued proposals for changes to the contract earlier this month, with a view to move away from rewarding processes and focusing on outcomes.
The proposals would stop additional payments for organisational tasks, such as good record keeping, which the DH says should be part of the work of any good health organisation.
But it would introduce payments for following NICE guidance, improving the diagnosis and care of people with a number of conditions, and providing access to online services.
The government has pledged that all patients will have online access to their GP records by 2015, and the NHS information strategy, ‘The Power of Information’ also endorses transactional services, such as booking appointments and repeat prescriptions.
Earl Howe told the conference that the government has promised to protect NHS funding, but that it expects big improvements for patients in return.
He also said the money saved by stopping financial incentives for carrying out organisational tasks would be reinvested in primary care; but it would be expected to deliver improved standards as a result.
Earl Howe also addressed the government’s commissioning reform agenda, and the ongoing debate about whether clinical commissioning groups should use NHS commissioning support services or private sector offerings.
He said GPs as commissioners will be able to draw on a wide range if commissioning support services, including those set up by the NHS, local authorities, the voluntary and private sectors.
"I want commissioning support to be part of a vibrant services industry where all the important work goes on behind the scenes,” he said.
"There will be no restriction on who you can use and as the customer you will be in control. Over time we want to see a blend of new and innovative services beginning to emerge that combine the best of what all the systems have to offer.”