The BMA’s GP Committee has rejected NHS England’s new GP contract for 2023/34, which has imposed more stipulations around access to practice but has offered no new funding.
The contract – published yesterday afternoon (6 March) – set out a number of changes to how general practice operates, including a major focus on increasing patient access, additional roles, and a review of the current QOF system with an overhauled model to come.
However, the contract was not agreed with the BMA GPC, which has described it as a ‘failure to listen to what GPs actually need’.
The GPC has also said it is now exploring all options following an imposition, including potential industrial action.
Under the contract for the upcoming year, GP surgeries will have to offer patients an ‘assessment of need’ upon first contact and will ‘no longer be able to request that patients contact the practice at a later time’.
ICBs have also been instructed to withhold 30% of the total funding for the IIF – about £73.8m – and allocate it following and assessment against ‘gateway criteria’ at the end of March 2024.
The other 70% of the total funding, equating to £172.2m, will be provided as a monthly payment to PCNs during the year, similarly to QOF.
The main changes in the contract include:
- An update to the contract to ‘make clear that patients should be offered an assessment of need, or signposted to an appropriate service, at first contact with the practice’
- The majority of the Investment and Impact Fund (IIF) – worth £246m – will be entirely focused on improving patient experience of contacting their practice and providing appointments within two weeks;
- Changes to the childhood immunisations payment system, with lowered thresholds for the QOF targets;
- The number of indicators in the IIF to be reduced from 36 to five (worth £59m), focusing on flu vaccinations, learning disability health checks, early cancer diagnosis as well as the two-week access indicator;
- Changes to the additional roles reimbursement scheme, including adding advanced clinical practitioner nurses to the reimbursable roles, increasing the cap on advanced practitioners to three per PCN and removing the caps on mental health practitioners.
NHS director of primary care Dr Ursula Montgomery said: ‘GP teams have worked hard to deliver record numbers of appointments with half a million more delivered each week last year compared to pre-pandemic, and this new contract aims to build on this further with more access for patients.
‘As well as providing same day care to more than two fifths of patients, GP teams will also step-up preventive action against heart attacks and strokes over the next year, with health professionals encouraged to prescribe statins alongside other preventative measures such as exercise to a much wider number of patients with heart disease, arterial disease and those who suffered a stroke or who have high levels of cholesterol.
‘This contract supports GP teams to provide what matters to patients, and later this Spring the NHS will publish the GP Recovery Plan on how access to care will be expanded even further.’
But the BMA GPC has called out the lack of funding beyond what was already agreed in 2019 as part of a five-year deal.
This article features additional reporting form our sister title, Pulse