Despite the steps forward in the 2016/17 contract deal announced today, there is little doubt that general practice remains in desperate need of a wide ranging rescue package that addresses the fundamental challenges threatening to overwhelm GP services across the country.
Practices are rightly fed up with the constant changes to their contract and so this year we have resisted further additions to clinical workload and have agreed that there will be no changes to the QOF in this 12 month period.
We’ve also successfully brought the previously imposed dementia enhanced service to an end with crucially a transfer of resources from it to core funding. That means a little less unnecessary box ticking which got in the way of treating patients properly. Importantly, GPC has also secured an agreement to explore the end of the QOF and the avoiding unplanned admissions enhanced service in the future.There will also be a long overdue 28% increase in the vaccination and immunisation item of service.
When it comes to practice expenses, there is further good news, with an agreed uplift of £220m to cover rapidly rising practice expenses. This will cover the coming year’s rise in CQC fees, rising indemnity costs and the many other cost pressures of running a practice.
It should also lead to a 1% pay increase, which is better news after the repeated pay cuts most GPs have experienced in previous years. This of course is partly tainted by the fact that the exorbitant and disproportionate fee rises currently proposed by the CQC should never have been on the drawing board in the first place, especially after a year marked by U-turns and failure. But this extra money will at least cover the cost this year.
State of emergency
However, whilst this deal on expenses is welcome, I have made it very clear to the government that these changes will not address the wider pressures bearing down on a service which is in a state of emergency.
As the LMC special conference heard time and time again at the end of January, GP services are being stretched to breaking point after years of political neglect. We are facing a steady, rising curve of demand from an increasingly complex pool of patients, especially caused by our ageing population who need a lot more care closer to home.
Despite this problem – which has been evident for years – we remain significantly underfunded and under staffed without the infrastructure or support to deliver the service the public expects.
Increasingly the media is noticing the plight of general practice: the BMA’s recent survey into the parlous and struggling state of GP practices received blanket coverage and we have launched a new resource package, an urgent prescription for general practice, which gives GPs some useful tools to help tackle some of the issues they face.
Politicians slow to act
But politicians continue to act as if they are stuck in treacle. The much heralded investment fund in GP premises remains mired in delays, there is little sign that the 5,000 extra GPs promised during the election campaign will soon materialise and most importantly there remains no costed, fully planned package to recuse general practice from its parlous state.
It may sound dramatic to talk of a 'rescue' being needed, but the vast majority of general practice cannot carry on in this state. We cannot continue in a climate of short changing patients and GPs while the demands continue to threaten to close more GP practices. It is time for the government to recognise the warning signals and act immediately.
Photo: Alex Deverill