A new five-year GP contract has been agreed, with £405m of funding confirmed for 2019/20 that will in part be used to support practices to join networks.
The contract, which has been negotiated by NHS England and the BMA’s GP committee and is effective from April, will provide practices with almost £1bn of core funding over the five years – plus an additional £1.8bn investment in primary care networks.
This will include guaranteed increases into the global sum, a new direct enhanced service (DES) worth around £2 a patient for practices to join networks and funding for new healthcare workers, as well as an indemnity scheme to cover GPs and all practice staff.
The DES regulates the more specialised services a practice is expected to offer and is designed to cover the ‘enhanced aspects of clinical care’ that extend beyond the limits of what is considered to be essential services.
The BMA said the £405m provided for 2019/20 means practices would be able to increase staff pay by at least 2%.
Under the contract, there will be funding uplifts to the global sum of around 1.5% a year, which can be adjusted if the economy experiences particularly high or low inflation.
In addition, the new ‘practice participation’ DES will account for funding worth an extra circa 1.5% increase on the total core contract a year.
This is on top of the funding for the state-backed indemnity scheme. The full details of the funding will be announced later today.
Other changes under today’s announcement include:
- NHS 111 direct booking into practice appointments at a rate of one appointment per 3,000 patients available per day
- Increased digital access for patients, meaning practices will be able to make 25% of appointments bookable online
- £20m annual funding for practices to deal with subject access requests following the removal of the ability to cover costs under GDPR legislation. Practices will also have access to a data protection officer through their CCG to provide support on GDPR issues
- An agreement by the BMA and NHS England to put forward joint proposals to the Government addressing the issue of tax charges once annual and lifetime pensions contributions are breached
Ian Dodge, national director for strategy and innovation at NHS England, who led discussions with the BMA, said: ‘General practice is the bedrock of the NHS, and the NHS needs general practice to survive and thrive.
Through this comprehensive deal, the BMA and NHS England have sought to solve the big problems that general practice faces, and make it possible to expand services for patients.’
Dr Nikki Kanani, a GP and NHS England’s acting medical director for primary care, said: ‘This contract gives five-year funding clarity and certainty for practices while giving patients improved services.
‘Primary medical and community care resources will increase by £4.5 billion by 2023-24 and rise as a share of the overall NHS budget.
And this agreement confirms how much of this new investment will stabilise and transform primary care through general practice and the evolution of primary care networks. It’s a game changer and signals the start of a new era for general practice.’
Dr Richard Vautrey, BMA GP committee chair, said: ‘We are confident that these widespread changes – the most significant in 15 years – will deliver the best not just for GPs across England, but also for the patients they treat on a daily basis.
‘Recent years have seen hard-working family doctors deal with anverstretched workforce doing their best to meet rising demand from patients suffering more and more complex conditions, all on the back of a decade of underinvestment in general practice.
‘Therefore, we are pleased after months of discussions with NHS England, to have negotiated a package of reforms to the GP contract and beyond, that will begin addressing the unsustainable situation – whereby doctors are choosing to leave the profession while patients wait longer and longer for appointments – and laying the foundations for a general practice fit for the future.’
Key elements of the five-year GP contract
- £405m investment through the practice contract and ‘network contract’ in 2019/20, meaning every practice will be able to uplift staff pay by at least 2%
- Overall investment of £1bn core funding over the five years
- Establishing primary care networks across England by July 2019, backed by £1.8 billion of funding by 2023. Networks will be led by a local GP in a clinical director role.
- Primary care networks will receive 100% recurrent funding to employ social prescribers and 70% for clinical pharmacists in 2019/20, and the same for physiotherapists, physician associates and paramedics as they are introduced.
- The introduction of a state-backed indemnity scheme beginning in April 2019.
- Increased digital access for patients, meaning practices will make 25% of appointments bookable online, improve their online presence and give new patients access to their digital records as standard.
- An agreement between the BMA and NHS England to make joint representation to the Government with proposals to reduce the problem created by the pension annual allowance, to address the impact this is having on GP recruitment and retention.
- NHS 111 direct booking in to practice appointments at a rate of one appointment per 3,000 patients available per day. This will happen only after triage.
- Funding for practices to deal with subject access requests following the removal of the ability to cover costs under GDPR legislation. Practices will also have access to a data protection officer (DPO) through their CCG, to provide support on GDPR issues.
- QOF changes to remove unnecessary indicators and provide a focus on professionally-led quality improvement.
This story was first published on our sister publication Pulse.