BMA to hold special conference after GP leaders reject 2020 contract offer

GP leaders have voted to hold a special conference after rejecting a package of contract changes for 2020/21, including the controversial service specifications for the network DES.

The special conference - to be held 'as soon as is practicable after contract negotiations have concluded' - will consider changes to the GP contract that could take effect from April 2020.

GP leaders voted to hold a special conference after the BMA's GP committee voted by a huge margin to reject a package of contract changes, in the latest blow to the five-year contract deal that took effect from April 2019.

GPonline understands that 80% of those who voted at a GPC meeting on Thursday rejected the contract offer.

GP contract

The move to hold a special conference comes after a wave of criticism of draft specifications for the network DES - a key plank of the five-year contract that underpins the creation of primary care networks (PCNs - leaving the future of networks in serious doubt.

Beyond the network DES proposals, details of contract changes rejected by GP leaders remain confidential. But changes expected from April 2020 under the five-year agreement include all practices providing online consultations, changes to the QOF around heart failure, asthma and COPD - and a 2.3% uplift to core pay.

The GPC voted to 'condemn' the draft network DES specifications and to hold an emergency conference that will consider 'the outcome of the 2020/21 GP contract negotiations and what action the profession should take'.

BMA GP committee England chair Dr Richard Vautrey said: 'The message from GPs in recent weeks has been a clear one: proposals put forward by NHS England and Improvement before Christmas have clearly been judged by the profession as unreasonable, and completely unachievable.

Primary care networks

'At a time when demand and workload for practices are unprecedented, GPs working on the front line felt these draft specifications piled on more pressure and would undermine primary care networks that were only just getting off the ground.

'This overload would therefore put in jeopardy all of the good work and progress PCNs have already made for the good of both staff and patients.

'Even in the short time GPs were given to respond to the consultation, NHS England and Improvement was overwhelmed with feedback, which was unanimous in its condemnation. Now GPC England – which is elected to represent GPs across England – has made its own position clear and we will now go back to NHS England and Improvement to seek a way forward.

'This is therefore not the end of the process, we have a clear mandate from our colleagues, to negotiate a deal that truly benefits and safeguards general practice, family doctors and their patients.'

GP costs

Accountants warned this week that the contribution practices are expected to make to the cost of hiring extra staff through PCNs could strip £400m from GP funding - while one LMC warned that practices could face costs of more than £100,000 per year each if they remained in PCNs.

Senior doctors leading networks have threatened to pull out, and at least one has already quit over the plans - although NHS England has stressed that they remain in draft form and that it is open to changing them.

The RCGP has joined calls for a rethink on the draft network DES specifications - warning that in their current form the plans create a 'clear risk' that PCNs will fail.

Following the vote, Londonwide LMCs chief executive Dr Michelle Drage said NHS England had 'underestimated the strength of feeling among the profession' over the need for investment in core GP services.

She added: 'The decision to call a special conference will ensure that local representatives of the grassroots have the ability to decide on any negotiated contract deal in the coming weeks. With GPs and practice teams working flat out we need to stabilise the existing services which so many patients rely upon before considering whether there is the capacity to take on additional responsibilities, and any such new activity needs proportionate resourcing.'

NHS England director of primary care and system transformation Matt Neligan wrote on Twitter this week that there had been 'lots of feedback to date that tells us we need to make changes', adding that NHS England was 'committed to doing just that'.

A DHSC spokesperson said: 'General practice plays a crucial role in delivering outstanding care to patients at the heart of our communities. That’s why we’re backing primary and community care with an extra £4.5bn by 2023/24 and have committed to growing the workforce by 6,000 more doctors and 6,000 more primary care professionals, helping to deliver an extra 50m appointments a year for patients.'

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