From April an additional £157m will go into the global sum from the unplanned admissions DES, which is to be scrapped.
An expenses and pay uplift has been agreed to deliver a 1% pay rise for GPs, as well as a £3.8m uplift to cover increased superannuation costs of NHS pension changes. An extra £58.9m will be invested to cover the cost of population growth.
Under the new deal, from October practices which close half a day during the week will not normally be eligible for funding under the extended hours DES. The GPC said this will not affect practices with local agreements for branch or small practices, and will not affect practices closing once a month for staff training.
The contract deal also includes £30m to cover rising GP indemnity costs. Practices will receive a share of the fund on a per patient basis, and the GPC has warned that it expects partners to ensure salaried and locum GPs receive fair shares of the uplift.
Practices that work together to provide more evening and weekend appointments will be eligible for additional non-contractual funding over and above the current scheme.
Practices will also be contractually required to determine a new patient’s eligibility for NHS healthcare to help the service recover costs from overseas visitors.
Chief executive of NHS England Simon Stevens said: 'We're now turning the corner on a decade of underinvestment in GP services, but with new cash clearly tied to new ways of working that both improve patient care and support family doctors. While this new national contract is just one piece of the jigsaw, it's another concrete step towards more convenient appointments for patients and more time for GPs to look after frail older people.'
NHS England director of primary care Dr Arvind Madan said: ‘This is really positive news, especially the agreement between NHS and the BMA to put a mainstream focus on frail older patients. This will help GPs focus their time and resources on the areas that matter most to their patients.’
GPC chair Dr Chaand Nagpaul said: 'I am pleased to say we have reached an agreement which we believe offers important and significant improvements to the contract.
'The changes will provide some much needed stability and respite for GP practices by reducing bureaucracy and providing financial relief in key areas. Progress on ending the bureaucratic unplanned admission DES is welcome as it will enable GPs to spend more time looking after frail older patients, rather than on box ticking.
'Reimbursements for CQC fees and rising costs of indemnity will protect practice resources so that they can be concentrated on frontline care for patients. Guaranteed cover for reimbursement to the sickness and maternity leave system will help practices continue to provide GP appointments when staff are unwell.
'It is encouraging that NHS England were prepared to listen to GPs' concerns in many of these areas and work with the BMA’s GP committee to deliver workable solutions.
'However, we should not pretend that these changes will solve the enormous challenges confronting general practice that have left many GP practices facing closure. Stagnating budgets, staff shortages and rising patient demand are combining to overwhelm services in many areas of the country.'
Main points of the 2017/18 contract:
- Unplanned admission DES scrapped and £156.7m added to the global sum
- 1% pay rise.
- £3.8m uplift for pensions superannuation.
- £58.9m for population growth.
- £30m for rising indemnity costs.
- £2m extra to cover additional costs of medical records handling created by primary care support services.
- Fee per health check under the learning disability DES raised from £116 to £140.
- Changes to elibility criteria for vaccinations.
- Practices closing half a day in the week ineligible for extended hours DES funding from October 2017.
- Practices collaborating to provide additional appointments outside core hours will get extra funding.
- Practices required to check new patients’ eligibility for NHS care and identyify those with non UK EHICs or S1 forms, supported by recurrent funding of £5m.
- Workforce census will become a contractual requirement with £1.5m added to core funding to cover the workload.
- A new GP retainer scheme with tighter criteria for joining. Practice payments will remain the same as the 2016 interim scheme to be sued towards the GP's salary.
- No changes to QOF indicators. QOF point value to increase. A working group will immediately begin work on the future of QOF after April 2018.
- All practices will be required to allow collection of data for the national diabetes audit and a selection of agreed indicators retired from QOF and enhanced services.
- Prisoners will be allowed to register with a practice before leaving prison to enable better care.