Charlton Rodger
University of Warwick, Coventry.
Clin Med (Lond). 2005 Jan-Feb;5(1):50-4. doi: 10.7861/clinmedicine.5-1-50.
A new contract for general practitioners (GPs) was introduced in the UK on 1 April 2004 which has implications for secondary care. In particular, the contract means that GPs can opt out of out-of-hours care, and accident & emergency services have voiced their concern that their workload may increase as a result. The new contract provides the potential for a rise in GPs' salaries by two means: through the provision of the Quality and Outcomes Framework which includes the management of 10 common chronic diseases; and through 'Enhanced Services', which are a series of optional 'extra' more specialised services with national specified standards that can be commissioned by primary care organisations (PCOs).
2004年4月1日，英国出台了一项针对全科医生的新合同，这对二级医疗保健产生了影响。特别是，该合同意味着全科医生可以选择不提供非工作时间的医疗服务，而事故与急救服务部门已表示担心这可能会导致其工作量增加。新合同通过两种方式为全科医生提高薪资提供了可能性：一是通过提供包含10种常见慢性病管理的质量与结果框架；二是通过“强化服务”，这是一系列具有国家规定标准的可选“额外”更专业服务，可由初级医疗保健组织（PCOs）委托提供。
