The new GP contract package for England will allocate £94m to address recruitment and retention issues and includes a £20,000 golden handshake for new partners in areas with severe GP shortages.
The British Medical Association’s (BMA's) GP England Committee (GPCE) has voted to accept a package of changes to the GP contract for 2020-21, which includes funding to attract more doctors to take up partnership roles and expand the practice team seeing patients in surgeries.
The agreement, which builds on the five-year deal announced last year, is the result of months of negotiations between the BMA and NHS England and NHS Improvement and comes three weeks after GPCE rejected an earlier deal.
The BMA says draft service specifications for Primary Care Networks (PCNs) – outlining the responsibilities of these groups of practices and community providers in the coming years – have been “significantly pared” back after widespread criticism from the profession that draft versions published by the NHS at the end of last year were “unfair, unrealistic and burdened already struggling-practices with unsustainable workloads”.
GPs will not now be asked to perform fortnightly care home visits as earlier proposed. Instead, working with a community multidisciplinary team, it will be for PCNs to decide who delivers a weekly review of those care home residents, based on clinical need. Networks will also receive £120 per care home bed to reflect the varying size of populations. The extent to which PCNs provide structured medicine reviews with patients will now depend on the capacity of the clinical pharmacists recruited.
The package also includes:
- 100% reimbursement for all additional staff recruited via the PCNs
- £173m for PCNs to employ a wider range of professionals to help manage workload and provide appointments, including pharmacy technicians. These build on previously agreed roles such as clinical pharmacists, physiotherapists and paramedics.
- A greater proportion of GP trainees’ time spent in general practice. This means GP trainees will spend 24 months of their 36 months’ training in general practice (up from 18 months), with the remainder spent in hospitals and other settings.
- Funding to pay for childcare for doctors returning to general practice through the GP Induction and Refresher Scheme.
- Plans to introduce enhanced shared parental leave arrangements for salaried GPs.
- Funding to support practices to deliver a 6-8 week postnatal health check for new mothers.
- An above inflation pay uplift for staff, as agreed in the 2019/20 deal.
Dr Richard Vautrey, GPC England chair, said: “The significant investment in and focus on recruitment and retention, including payments to incentivise doctors to take up partnership roles and work in under-doctored areas, is a vote of confidence in the partnership model and a much-needed first step if we are to reverse the worrying trend of falling GP numbers that we have seen in recent years.
“An expanded healthcare team working in GP practices as well as increasingly closely with community colleagues across groups of practices, will mean patients have access to a wider range of staff, allowing GPs to see those who need them most more quickly. These extra roles are now fully funded so will come at no extra cost to practices.
“These changes won’t fix the crisis gripping general practice overnight and we recognise there is much more work to do to address the real concerns that GPs and LMCs have expressed in recent weeks. However, they are a significant step in the right direction.”
RCGP chair Professor Martin Marshall, described the contract as “encouraging” and was pleased that government had listened to GPs concerns over specifications for PCNs.
"We hope it will serve as a catalyst to deliver the funding and workforce pledges that have been made and are so desperately needed to ensure general practice is sustainable in the future.
"This contract should help us to deliver services that will be beneficial for patients whilst relieving workload and providing much needed support for hard pressed GPs.”