Change in GP Psychological Contract Post-1997: Lambeth PCT

Level: Masters | Grade: Masters Pass | Approx. Word Count: 2,178

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The aim of this study is to provide an analysis of the affect that the revised GMS contract agreed between the two parties has had on the psychological contract that exists between GP and their PCTs, and to provide highlight areas where improvements may be beneficial. The relationship between Lambeth PCT and its GPs will provide the basis for analysis and evaluation.

In was in 1977, following a change to a Labour government in the UK, that the National Health Service (NHS) began to be subjected to major reforms. This change resulted in the creation of local and regional Primary Care Trusts (PCTs) that would assume responsibility for the quality of all healthcare organisations and activities in their designated areas, which included GP practices. The purpose of these reforms was focused on adopting a patient-centred approach with the objective being to raise the standard of the primary care services provided. As an integral part of this process the Department of Health (2003), following discussion with the BMA, agreed a revised GMS1, which was to come into force in 2004. This revised contract resulted in changes to GPs remuneration package and to their working practices. It has long been argued that the effectiveness of the change process in any organisation is reliant on the extent to which the management can gain the motivation, involvement and support of the workforce (Armstrong 2012), in this case GPs. For this purpose, it is critical for mangers to develop a robust relationship with the GP, which should take the form of a “psychological contract” (CIPD 2005: 1).