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GP contract for England brings overall 3.4% increase

New 2018/19 contract includes £60m to cover rising indemnity costs, more premises investment

Louise Prime

Wednesday, 21 March 2018

The BMA General Practitioners Committee (GPC), NHS England and the government have agreed the 2018/19 GP contract for England, which will see an overall investment of £256.3m going into the contract – a 3.4% increase – including £60m to help practices to cover increased costs of indemnity.

NHS England chief executive Simon Stevens said the new contract, which takes effect from 1st April, “[…] is a further concrete step in investing in and strengthening general practice, which is at the heart of our modern NHS.”

The GPC welcomed the changes as a step in the right direction, but warned that the government needs urgently to provide general practice with the proper funding and support it needs to guarantee the future of the profession and ensure safe and high-quality care to patients.

The new contract includes agreement on:

  • an initial 1% pay uplift and inflationary uplift to expenses, expected to be increased further through any recommendation from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), due later this year, and which will be backdated to 1 April;
  • £60m to cover in-year rising indemnity costs;
  • changes to Premises Cost Directions to enable further investment in GP premises, and clarification on issues related to last person standing;
  • £10m to support implementation of e-Referral Service, to make it available at every GP practice by this October;
  • uplifts for services fees for specific vaccinations and immunisations;
  • improvements in funding for sickness and maternity/parental/adoption leave cover;
  • strengthened regulations on violent patients;
  • completing roll out of the Electronic Prescription Service, allowing prescriptions to be sent direct to pharmacists;
  • widening piloting of NHS 111 directly booking GP appointments at practices that want to participate;
  • working together to encourage development and use of social prescribing.
The BMA said it hoped the interim funding increase would help practices and provide some stability, but added that it will not solve the ‘fundamental issues impacting general practice’ on which it said the GPC is ‘committed to focusing’ over the coming months.

GPC chair Dr Richard Vautrey said: “After a decade of pay cuts, it is time GPs and their staff received a proper pay increase. We have therefore provided strong evidence to the DDRB that doctors should be given an uplift of RPI + 2%, to bring us in line with the wider economy and we expect the government to fund any DDRB recommendation.”

He argued that GPs are in a uniquely disadvantaged position within the NHS in terms of both indemnity and practice premises, and pointed out that GPs must effectively pay an indemnity tax of many thousands of pounds compared with their consultant colleagues, while new GPs who want to become a partner ‘are too often expected to buy into the bricks and mortar of a practice’. He said the GPC is working closely with DHSC on a state-backed indemnity scheme for general practice, to be implemented in April 2019, and on a major review of the Quality and Outcomes Framework (QOF), as well as having secured the £60m to cover the rising cost of indemnity fees from 2017/18.

But Dr Vautrey warned: “While these changes are a further step in the right direction, and build on the important improvements last year, what is urgently needed is for the government to continue to work with the BMA to provide general practice with the proper funding and support it needs to guarantee the future of the profession and ensure safe and high-quality care to patients.”

Meanwhile the BBC said it understands that more than a million NHS staff in England, including nurses, porters and paramedics, can expect Treasury-funded pay increases of at least 6.5% over three years in a deal that, if approved, which would mean their pay could increase almost immediately.

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