BMA demands premises investment to improve 1,000 GP practices

The BMA's top GP has called for a significant rise in capital spending to improve 1,000 practice premises as thousands of new staff join the primary care workforce over the next four years.

BMA GP committee chair Dr Richard Vautrey called for a rapid solution to the pensions tax trap and more work to address the gender pay gap in general practice - but welcomed steps in the 2020 GP contract deal to encourage GPs into partnership roles.

Dr Vautrey also called for a cross-government review into reducing ‘the bureaucracy and unnecessary burdens’ GPs have to deal with ‘day on day’ - and suggested the government was close to backing the move.

The GPC chair was speaking at a conference for primary care network (PCN) clinical directors on 8 February, just days after the BMA and NHS England agreed a GP contract update for 2020/21, which included significant changes to the network contract DES.

Through the additional roles reimbursement scheme (ARRS), practices have been supported to hire an additional 26,000 staff into general practice, which could see the average primary care network (PCN) take on 21 new staff by 2023/24.

Unsuitable premises

However, with half of GPs and practice managers admitting that their premises are not suitable for present needs, Dr Vautrey warned premises across the country needed government investment to accommodate a ‘growing workforce’.

The Leeds GP also highlighted that the government had secured a £2.8bn investment in hospital premises and asked why a similar programme could not be planned for general practice in next month’s budget.

‘One of the problems we still have to address is where to put these [additional staff]. We know the issues of premises and funding for premises is something that has to be addressed,’ he said.

‘We need the government, through their annual cycle of investment, to invest in capital costs so, not only can they build 20 new hospitals, but maybe they can reform 1,000 general practices across the country so we have the space to site this growing workforce and deliver good quality care.'

The GP leader also reiterated that additional roles staff should be used by practices to alleviate the ‘existing workload burden’ as well as deliver national service specifications.

Concerns over the pension tax trap that has forced thousands of GPs to reduce their working hours was another issue priority issue highlighed by Dr Vautrey.

Punitive tax rules

In recent months, NHS capacity has been severely undermined by tax on pensions as doctors across primary and secondary care take steps to avoid punitive charges. BMA leaders warned last month that a proposal to raise the income threshold at which tax on pensions kicks in would fail to solve the NHS workforce crisis.

Dr Vautrey assured delegates that the BMA was ‘continuing to put pressure on NHS England and the government’ to tackle the annual allowance charge and said he hoped for an update ‘very, very soon’.

‘The government has made a commitment to enable doctors including GPs to have the repayments through the scheme pays mechanism of their pensions to have that annual allowance tax charge offset,' he said. 'But what we haven’t yet landed is an explicit mechanism for that to happen.

‘We are hoping that will happen in the next few days or weeks, because we have to get that back in place to give people confidence back about how they can avail themselves of that commitment government has already made  and we’ll try to ensure that’s with you very, very soon.’

Increasing confidence in the GP partnership model was also another factor the government must prioritise, the GPC chair said - calling for more work to ‘reduce risk’ for partners.

GP partnerships

Last year, an independent review of the GP partnership model warned that the partnership model 'could be lost' without steps to bring in new partners and retain existing members. Meanwhile, in the year to September 2019 nearly 1,000 full-time equivalent GP partners were lost to the profession.

Dr Vautrey said measures to give new partners a £20,000 ‘golden hello’ would help to address declining partner numbers and stop people being ‘put off’.

‘For the first time we are prioritising partnership recruitment and investing that £20,000 plus not just in that loan, in that will be a payment by the end of five or six years time and it will be retained by the doctor.

‘We are also investing in their training as well, to invest in that opportunity of business training. So if you are confident to take on the role of being a partner and to lead that team that you’ll be developing over the next few years.’

Meanwhile, the Leeds GP revealed BMA plans to address the gender pay gap within general practice, admitting the gap was ‘much wider’ for salaried GPs. He said: ‘We have a challenge, we have to own it and we now have to do something about it and we will be starting to tackle that over the coming months.’

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