The Department of Health (DH) and the British Medical Association (BMH) have agreed a £238m overhaul for the 2017/18 GP contract. This will see funding cover rising expenses and CQC fees as well as the unplanned admissions Direct Enhanced Services (DES) being scrapped. £157m will also go into the global sum from the unplanned admissions DES from April 2017.
A deal has been agreed for an expenses and pay uplift, which will see a 1% pay rise for GPs, as well as an uplift of £3.8m to cover increased superannuation costs of NHS pensions changes. With the population growing, an extra £58.9m will be invested in order to cover the costs of it.
Practices which close for half a day during the week will now not normally be eligible for funding under the extended hours DES from October, the new deal states. This will not affect practices closing once a month for staff training and nor will it affect practices with local agreements or for branch or small practices, according to the GPC.
It has also been agreed in the deal that £30m will be included in order to cover rising GP indemnity costs, while the GPC has also warned that it expects partners to make sure that salaried and locum GPs receive a fair share of the uplift after it was announced that practices will receive a share of the fund on a patient per patient basis.
To help the service recover costs from overseas visitors, practices must now determine a new patients NHS eligibility for healthcare under the new contract. Additional and non-contractual funding will be available for practices that work together to provide evening and weekend appointments.
“Much needed stability”
GPC chair Dr Chaand Nagpaul said: “I am pleased to say we have reached an agreement which we believe offers important and significant improvements to the contract. The changes will provide some much-needed stability and respite for GP practices by reducing bureaucracy and providing financial relief in key areas. Progress on ending the bureaucratic unplanned admission DES is welcome as it will enable GPs to spend more time looking after frail older patients, rather than on box ticking.”
“Reimbursements for CQC fees and rising costs of indemnity will protect practice resources so that they can be concentrated on frontline care for patients. Guaranteed cover for reimbursement to the sickness and maternity leave system will help practices continue to provide GP appointments when staff are unwell.”
“It is encouraging that NHS England were prepared to listen to GPs’ concerns in many of these areas and work with the BMA’s GP committee to deliver workable solutions. However, we should not pretend that these changes will solve the enormous challenges confronting general practice that have left many GP practices facing closure. Stagnating budgets, staff shortages and rising patient demand are combining to overwhelm services in many areas of the country.”
The 2016/17 GP contract in summary
- Unplanned admission DES scrapped and £156.7m added to the global sum
- 1% pay rise for GPs.
- £3.8m uplift for pensions superannuation.
- £58.9m for population growth.
- £30m for rising indemnity costs.
- £2m extra to cover additional costs of medical records handling created by primary care support services.
- Fee per health check under the learning disability DES raised from £116 to £140.
- Changes to eligibility criteria for vaccinations.
- Practices closing half a day in the week ineligible for extended hours DES funding from October 2017.
- Practices collaborating to provide additional appointments outside core hours will get extra funding.
- Practices required to check new patients’ eligibility for NHS care and identify those with non UK EHICs or S1 forms, supported by recurrent funding of £5m.
- Workforce census will become a contractual requirement with £1.5m added to core funding to cover the workload.
- A new GP retainer scheme with tighter criteria for joining. Practice payments will remain the same as the 2016 interim scheme to be sued towards the GP’s salary.
- No changes to QOF indicators. QOF point value to increase. A working group will immediately begin work on the future of QOF after April 2018.
- All practices will be required to allow collection of data for the national diabetes audit and a selection of agreed indicators retired from QOF and enhanced services.
- Prisoners will be allowed to register with a practice before leaving prison to enable better care.
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