We understand the complexities of the GP contract changes and their impact on daily operations for our Locum staff and the practices they work in.
Eligo Medical is committed to supporting GPs and practices through these challenging times.
Feeling lost with the latest GP contract changes? We've got you covered.
Here's a simplified breakdown of the key points impacting practices in England and what’s next:
Money Matters:
Funding increase: A small rise (2.23%) is planned, but it likely won't keep pace with inflation or rising patient numbers.Pay and staffing: The contract assumes a 2% pay raise for staff, but this might not cover actual increases, potentially impacting practice funding.
ARRS scheme: The scheme expands to include "enhanced nurses," though the exact definition remains unclear. Caps on "direct patient care roles" are lifted, but overall funding hasn't significantly increased. The BMA's push to include GPs in ARRS wasn't successful.
QOF Changes:
Good news: Aspiration payments for the Quality and Outcomes Framework (QOF) will rise from 70% to 80%, improving cash flow.
Some protection: Income for disease registers and specific areas like mental health and cancer will be protected.
Mixed bag: While some workload-heavy indicators are protected, others are suspended with unclear details about future payment calculations.
Data and Continuity:
More data collection: Practices will need to provide data on call volumes and wait times, potentially leading to additional administrative burdens.
Focus on continuity: The contract emphasizes considering the continuity of care when responding to patients, but how this will be measured and enforced remains unclear.
PCN DES (Network Contract):
Simplification (maybe): Eight service specifications within the PCN DES are merged into one. The impact and purpose of this change are unclear.
Investment and Impact Fund (IIF): Funding priorities shift, with a focus on learning disabilities and cancer, while flu and access indicators are dropped.
Clinical Director role: Funding moves into core PCN funding, and responsibilities are redefined to emphasize service delivery coordination and supporting practice transformation.
Performance List:
More flexibility: Practices have more freedom to employ non-GP doctors already working for NHS trusts, but these doctors can't see undifferentiated patients (unlike physician associates).
What's Next?
In a strong rejection of the government's offer, the BMA GPC England has called the 2024/25 contract changes an "intentional, predetermined, strategic, non-evidence based, ideological dismantling of NHS general practice." They launched a referendum among BMA GP and GP Registrar members in England from 7-27 March to gauge the profession's views on the contract.
The referendum result won't prevent the government from imposing the contract but will send a powerful message. Dr. Katie Bramall-Stainer, BMA GPC England chair, believes the current offer fails to address critical issues like inflation and staffing shortages, potentially harming practices and ultimately, patients.
Dr. Bramall-Stainer highlighted several key points in a letter to Jeremy Hunt:
- Significant funding gap: GP surgeries have faced a 21.2% inflation rise since 2019, while the current offer represents a meagre 1.9% increase.
- Shrinking workforce: There are 1,312 fewer GP practices compared to 2015.
- High return on investment: NHS spending on primary care offers a 14x return on investment in terms of economic growth.
Dr. Bramall-Stainer urged Mr. Hunt for a "personal intervention" to explore solutions and stabilize general practice before the end of March.
We'll keep you updated on the referendum results, potential industrial action, and resources to help clinicians and practices navigate these challenging times.
Sources:
British Medical Association
Pulse News
GP Online News
NHS England