Annual GMS contract negotiations between the GPC and NHS Employers have secured a 1% pay uplift for practices and reimbursement of rising expenses including higher CQC fees, practice upkeep and staff costs.
But GP leaders warned that while the deal is a ‘a step forward’ the service still needs a wider package of reforms to address the pressures they say are overwhelming practices.
The government and NHS England have said they will anounce a package of measures to support the service some time this month. Jeremy Hunt has said the announement would include measures to cut beaurocracy and details of how new investment will be spent.
As part of the GP contract deal for 2016/17 both sides have committed to explore ending the QOF and unplanned admissions enhanced service from April 2017.
Under the contract practices will be required to record data on the availability of evening and weekend routine appointments until 2020/21. In addition, they will have to record how often they pay locums more than an indicative maximum rate, which will be set by NHS England.
The deal also delivers a 28% increase to the vaccination and immunisation item of service fees from £7.64 to £9.80 and the dementia enhanced service will come to an end, with funding transferred into core pay.
Details of the 2016/17 contract:
- Increased investment of £220 million into the GP contract to deliver a 1% pay uplift and reimbursement to meet rising expenses facing practices, including higher CQC fees, practice upkeep and staffing costs.
- An end to the dementia enhanced service with a transfer of £42m resources to core funding.
- No new clinical workload schemes or changes to the QOF
- Joint commitment to explore the end of the QOF and 'Avoiding Unplanned Admissions' enhanced service.
- A commitment to a national strategy to reduce bureaucracy and manage demand on GP services.
- A 28% increase to the vaccination and immunisation item of service fees from £7.64 to £9.80.
- GP practices will be required to record data on the availability of evening and weekend opening for routine appointments, which is to be collected until 2020/21
- GP practices will record annually the number of instances where a practice pays a locum doctor more than an indicative maximum rate, as set out by NHS England.
GPC chairman Dr Chaand Nagpaul said: 'GPC was clear from the outset that these annual variations to the contract could not resuscitate general practice from the brink of collapse following years of underfunding, rising patient demand, staff shortages and unresourced work being moved from hospitals into the community.
'These limited changes provide some immediate financial support which for the first time in years recognises the expenses being incurred by practices and resources needed to deliver a pay uplift rather than a pay cut.
'There is no new clinical workload requirement or any change to QOF, and the deeply unpopular and imposed dementia DES will be removed with resources moving into core funding. The immunisation and vaccination item of service payment will increase by 28% from £7.64 to £9.80. There is also agreement to looking at ending QOF in its entirety and the avoiding unplanned admissions enhanced service in April 2017.
'However, these changes do not detract from GPC’s ultimatum to government demanding a clear rescue plan to sustain general practice in the immediate and longer term. We now need to focus on the real battle to revive general practice and which will require far broader solutions than tweaking the annual contract.'
Health secretary Jeremy Hunt said: 'GPs are the bedrock of the NHS and I am determined to provide the support they need so they can spend more time with patients. Today’s deal is just the start of significant new investment for general practice which will help GPs to provide a truly modern, efficient service every day of the week.'
NHS England chief executive Simon Stevens said: 'Today's welcome agreement between NHS England and the BMA provides GPs with some stability and support, and shows what can be achieved through sensible and constructive negotiation. However this contract is only one small element of a far wider package we're jointly developing to help practices with workload, workforce and care redesign.
'That will require radical new options, including further support for GP recruitment and return to practice, funding for additional primary care staff, new options for practice premises, a reduction in paper-based red tape, alternative approaches to indemnity cover, and redesigned out of hours, 111 and extended hours arrangements, to name just a few - all underpinned by much greater team working across individual practices.
'NHS England and GPC have also committed to take forward discussions in 2016 on a number of areas that include; a national approach to reducing bureaucracy and workload management in general practice, a national promotion of self-care and appropriate use of GP services, arrangements for sickness payments, an approach to calculating practice expenses and arrangements for identifying patients with EHIC or S1 and S2 forms through patient self-declaration.'
Photo: JH Lancy