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BMA reveals improvements to new GP contract

Less red tape on unplanned admissions, 1% pay uplift and easier sick and maternity claims

Louise Prime

Tuesday, 07 February 2017

The new 2017-18 GP Contract for England will cut bureaucratic workload over unplanned admissions, bring extra funding for the care of people with learning disabilities, direct reimbursement of Care Quality Commission registration fees, improve sickness and maternity absence cover arrangements, and improve the GP retainer scheme, the BMA has just announced.

The changes should also deliver a pay uplift of 1%. The BMA GP committee has also agreed changes to help to identify patients with a non-UK issued European Health Insurance Card (EHIC) – with a new recurrent investment of £5m added to global sum to support any associated administrative workload.

Chair of the GPC Dr Chaand Nagpaul wrote to GPs this afternoon with details of the changes agreed for the new contract:

  • Discontinuation of the avoiding unplanned admissions (AUA) direct enhanced service (DES) on 31 March 2017 to cut bureaucratic workload; £156.7m will be added to the global sum. There will instead be a contractual requirement that for those patients identified as living with severe frailty, the practice will deliver a clinical review providing an annual medication review and where clinically appropriate discuss whether the patient has fallen in the last 12 months and provide any other clinically relevant interventions.
  • Direct reimbursement of practices’ entire “exorbitant” CQC registration fees; this funding will not be added into global sum, and will therefore not be weighted with the Carr-Hill formula.
  • £30m to cover this year’s rises in insurance indemnity costs.
  • An increase in expenses that should deliver a pay uplift of 1%, to be added to global sum; an uplift of £3.8m to recognise increased superannuation costs of 0.08% resulting from changes to the NHS pension scheme that take effect in April 2017; £2m added to the contract to account for increases in practices’ extra workload (bagging and labelling patient records) as piloted changes to the primary care support services, provided by Capita, are extended across England; and £58.9m added to the contract to cover the estimated cost of increased population growth; £1.5m added to global sum to recognise the workload involved in the workforce census, which will be a contractual requirement for every practice.
  • Introduction of a system based on self-declaration to identify patients who hold a non-UK issued EHIC or S1 form when registering with a practice, to enable funding to be claimed back from the patient’s country of origin, with no upfront charge to the patient.  An extra £5m will be added to the contract on a recurrent basis to support any workload implications.
  • Greater investment by NHS England in the Learning Disabilities DES to support an increase in the uptake of medicals; the sum paid per health check will rise from £116 to £140.
  • Sickness cover reimbursement will now be a practice entitlement rather than a discretionary payment, with removal of the qualifying criteria based on list size.
  • Maternity payments will no longer be subject to a pro-rata application – in order to secure the payment, practices will need only to submit an invoice and either the full amount or maximum payable will be paid.
  • The BMA also said it had “committed to working with NHS England to ensure locally responsive, safe and appropriate access to general practice for all patients in England during contracted hours, with a particular focus on the minority of practices which currently close for a half day on a weekly basis”.

Dr Nagpaul commented: “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.”

But he warned: “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 … While many of these new arrangements are a step in the right direction, what we really need is for the government to properly resource general practice to ensure that GPs can provide the time and care needed to meet the increasing needs of patients.”

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