LMCs demand 'wholesale new GMS contract' to reverse underfunding

LMCs are calling on the BMA to negotiate a 'wholesale new GMS contract', warning that core funding for general practice has now been eroded to a level that is 'unsustainable and unsafe'.

GP leaders will debate the call to 'mandate GPC England to negotiate a wholesale new GMS contract' in a motion for debate at the annual English LMCs conference in London this month.

Annually negotiated adjustments to the current GP contract are 'failing to address the crisis in general practice', the motion warns.

It calls for recurrent uplifts to the global sum 'at least over and above inflation', multi-year contract deals to allow practices to plan and invest in developing new services, and 'index-linked' enhanced services payments.

Partnership model

A separate motion will also demand the abolition of the contract's out-of-area patient registration clause, amid concerns about the way it has allowed the controversial GP at Hand model to expand.

The debate will come just a fortnight after LMCs in Wales warn that the GMS contract faces 'collapse by default' unless action is taken to save the partnership model.

The GP contract is in line for significant change in 2019/20 as several major reviews near completion. The review of the GP partnership model led by Wessex LMCs chair Dr Nigel Watson is set to deliver its final report by the end of 2018 - while NHS officials, the BMA and others are also carrying out reviews of the QOF, premises arrangements and the GP funding formula.

Ministers have also suggested that the funding formula could be revamped to accommodate emerging digital-first models of care such as GP at Hand, amid concerns that the rapid shift of thousands of young patients to the service could destabilise existing practices.

Indemnity

The state-backed GP indemnity scheme is also set to take effect from April 2019, although the government has yet to reveal in detail how it will work - and concerns remain that part of the funding may come from existing GP income.

NHS England board papers published in July revealed that officials believe the GMS contract is in line for its biggest overhaul since the 2004 deal to scrap the old Red Book system.

GPs at the annual LMCs conference will also take part in a debate on the partnership review, following an opening speech from Dr Watson - and representatives will be asked to take part in live votes on elements of the partnership model.

LMCs will warn that CQC inspections add an 'unnecessary burden to the GP workload', call for a cap of 1,500 patients per full-time equivalent GP, debate calls for seniority pay for GPs to be restored, and condemn the government for refusing to implement a 4% increase in GP pay recommended by the DDRB.

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