The patient participation DES will be scrapped along with the alcohol enhanced service, with funding for both moving into core pay.
Elements of both these enhanced services will now become core contractual requirements, with practices expected to maintain a patient participation group and to identify newly registered over 16s drinking high levels of alcohol.
The avoiding unplanned admissions DES will be extended for a further year from April 2015. NHS Employers said there would be 'changes including revisions to the reporting process and changes to the payment structure'. The GPC hailed these changes as a 'significant reduction in bureaucratic reporting'.
QOF expansion ruled out
The GPC also welcomed an agreement that no new indicators or thresholds would be added to the QOF in 2015/16.
GP reported last week that health secretary Jeremy Hunt had told senior GPs he would like to see quality targets cut to 10% of GP income. Despite the deal for no new indicators to be added to QOF in 2015/16, NHS Employers said 'discussions around any clinical changes to QOF within the current QOF envelope will continue' - suggesting a reduction in QOF could go ahead from 2015.
The deal will also bring an end to uncertainty for practices over maternity leave funding, with practices guaranteed funds to provide locum cover. Funding is currently discretionary, with NHS England's area teams able to choose whether or not to offer it to practices.
Premises and workforce plan
BMA leaders and NHS England will also work together to develop a premises improvement strategy for primary care under the deal. The BMA said it had also secured an agreement that NHS England would work with it to 'develop solutions to workforce issues, focusing particularly on supporting GPs to remain in and return to the profession, recruitment problems in specific areas, such as remote and rural areas and the flexible careers scheme'.
The named GP proposal will mean practices must appoint 'a named, accountable GP for all patients (including children) who will take lead responsibility for the co-ordination of all appropriate services required under the contract'.
Plans to increase transparency on GP earnings will mean practices must 'publish average net earnings (to include contractor and salaried GPs) relating to 2014/15, as well as the number of full- and part-time GPs associated with the published figure'.
GPC chairman Dr Chaand Nagpaul said: ‘After tough negotiations, we have reached an agreement with the government which gives general practice a much-needed breathing space and greater stability for practices and patients. We have secured changes aimed at freeing up GPs’ time and improving patients’ experience of general practice.
'Measures to reduce bureaucracy, and allow family doctors to spend more time with patients are a step in the right direction.
Relentless pressure on GPs
‘At the same time, we must not lose sight of the relentless pressure on general practice from rising demand, declining resources and the move to transfer services from hospital into the community. We are now at a critical juncture, faced with a shortage of GPs, with surgeries closing and facilities in many practices increasingly inadequate to deliver high-quality care.
‘The government has said that it understands the pressures on GPs and their impact on patient care and access to services and that it is committed to delivering the necessary solutions. Now that we have agreed a contract for next year, we need the government and NHS England to work with us to address the immediate wider pressures on general practice - as set out in the BMA GP committee’s plan for short term measures - to ensure that general practice can be sustainable and have the capacity to deliver care that patients need.’
Further changes will allow armed forces personnel to register with GP practices for the first time, while planned reductions in seniority pay continue, along with work on improving recognition of deprivation in the Carr-Hill GP funding formula.