I wrote to you last week with details of our negotiated agreement for GP contract changes from April 2017.
I’m pleased that we have received positive feedback from many of you regarding these changes, which should relieve GPs and practice staff of bureaucratic work and provide more resources. To reiterate the main changes:
- Ending of the AUA DES (avoiding unplanned admissions direct enhanced service) in April 2017, with funding moved to core budgets. There will be a requirement to review patients living with extreme frailty, based on clinical judgement, with no forms to fill or claims to make
- Full reimbursement of CQC (Care Quality Commission) fees
- Practice payment to cover indemnity-fee rises
- Non-discretionary reimbursement to cover GP sickness absence, with no list-size criteria, and with provision for internal GP cover
- Learning disability DES payment uplift from £116 to £140 per check
- Recognition of specific expenses – increased employer NHS superannuation costs, increased workload in bagging and labelling notes from Primary Care Services England or Capita and completion of workforce census reports
- Five million pounds to cover administrative costs for new patient self-declaration of European Health Insurance Card or S1 status at registration
- An overall intended pay uplift of 1%
- The global sum per weighted patient is set to rise from £80.59 to £85.35 in 2017/18. This is a 5.9% increase overall.
Full details of the contract changes are available on our webpages here, and we have also produced a set of FAQs I hope you will find helpful. We are holding a GP contract webchat on Wednesday 22 February from 12.30pm to 1.30pm as shown below:
GP CONTRACT ‘YOUR QUESTIONS ANSWERED’ WEBCHAT
We will be hosting a live webchat on Wednesday 22 February from 12.30 pm to 1.30pm where colleagues (whether they are BMA or local medical committee members) can ask members of the BMA GPs committee executive and BMA staff questions about the GP contract changes in England for 2017/18, and how it will affect them. Please follow this link at 12.30pm next week to join (or register at that link now to receive a reminder when the webchat begins
We recognise that these contract revisions are not a panacea to the many wider challenges which face general practice, and which are largely a result of wider pressures outside our contract – with soaring demand, a critical shortage of GPs, chronic, inadequate NHS funding, excessive regulatory and bureaucratic burdens, and unresourced and inappropriate workload shift.
We continue our parallel discussions with NHS England and the Department of Health to tackle these wider issues – in part through ensuring NHS England honours its commitments in the General Practice Forward View, as well as those we are taking forward through our Urgent Prescription for General Practice campaign.
Increasing public awareness of our pressures
I appeared as a panel member on the Victoria Derbyshire programme last week, which had a special feature on the crisis in the NHS. Other panellists included RCGP chair Helen Stokes-Lampard, shadow health secretary John Ashworth, and a contribution from Dean Eggitt, BMA GPs committee member and secretary of Doncaster local medical committee as part of an interactive audience of lay people, patients and health professionals.
The programme followed a BBC survey showing that two thirds of those asked thought staff shortages and resources were the main reason for the pressures facing the NHS, highlighting that the public is no longer willing to be hoodwinked by empty political promises and gestures. I made the point that this crisis was of the Government’s own making, with savage cuts on top of a wholly inadequate NHS budget with fewer doctors and lower health spending compared to equivalent nations and that it was its responsibility to put this right. It was heartening to hear from the audience who spoke about the pressures facing GPs working under excessive workload, with workforce shortages and ever-diminishing resources – and that the message of the crisis affecting general practice is finally reaching the public.
The next day the BBC ran a story on the utter inadequacy of 10-minute GP consultations. It is positive that patients and the general public are now increasingly aware of the intolerable pressures on GPs trying to manage complexity and multiple morbidity in short consultation times, which undermines our professionalism and does not do justice to our patients. GPC has highlighted the importance of safe working levels as part of Urgent Prescription for General Practice, and has produced a specific paper on safe working, which is based on a locality hubs model of supporting practice overflow workload. My comments were featured in The Guardian and BBC News Online, and I also appeared on BBC news bulletins throughout the day on this story.
The Mirror and The Times reported a study in Pulse last week, which reveals that one-in-10 areas are being left without sufficient GP out-of-hours cover. This once again emphasises the reality of a serious shortage of GPs, and the fallacy in trying to divert GPs to provide extended routine access when we have not got the GPs available to attend to acutely ill patients out of hours.
GMC supports long-overdue recognition of GPs as specialists
I am pleased to report that the GMC recently issued a statement in support of expanding the specialist register to include general practitioners, which would put us on a deserved equal footing with other specialists, such as hospital consultants.
The statement notes that ‘GPs make a huge and vital contribution to healthcare in the UK, providing expert care and treatment to millions of patients every year. We accept the recent arguments made by the BMA and RCGP that a single advanced register – for both specialists and GPs – would make this expertise much clearer’.
While this is an important milestone, expanding the specialist register to include general practice will require the UK Parliament to update the Medical Act (which is the piece of legislation which determines the scope of the medical register). We will work closely with the RCGP and GMC to lobby for this long overdue change.
I would particularly like to thank Mary McCarthy, GPC member and vice-chair of European Union of General Practitioners, for her unstinting drive, vision and commitment in leading us to this pivotal point.
With best wishes,
BMA GPs committee chair
GPC elections – do you want to be a member of GPC?
We are seeking nominations for voting members of GPC to represent a range of regions across the UK. Elected members will serve for a period of three years from 2017 until 2020. Fifteen constituencies are up for election as listed on the GPC election webpage.
Nomination forms must be signed by the candidate and a representative of the LMC.
For more details, eligibility criteria and to download the nomination form, see bma.org.uk/gpcelections or contact firstname.lastname@example.org
Nominations close on 6 March 2017.
Members of the GPC executive, and the sessional subcommittee, have been speaking at a range of national roadshows across England over the past two weeks. These events provide an important opportunity for the GPC executive to receive direct feedback from grassroots GPs about the issues affecting them, and to share the work of GPC in representing the profession.
Roadshows have been held up and down the country, including Leeds, Birmingham, Cambridge, Bristol, Kent, Preston, Wessex, Hull, Surrey and Grantham, with more planned in Plymouth, Manchester, Surrey and London. You can find the full list of upcoming roadshows here. Contact your local LMC if you are interested in coming along.
|Working together to sustain general practice
GPC has long argued that collaborative working between practices is a practical, innovative and implementable way of managing workload, reducing bureaucracy and providing resilience and sustainability for individual practices. Findings from our survey late last year show that collaborative working is supported by GPs across the country.
GPC is holding a conference – Working Together to Sustain General Practice – for LMCs on 23 February, which will have speakers from a range of collaborative models from GP practices working in informal alliances, through to formal mergers and the creation of super partnerships and multispecialty community providers. We are pleased that NHS England chief executive Simon Stevens will be speaking about the support NHS England can provide for such collaborative working.
GP forward view monitoring
As you know, GPC has been at the forefront of ensuring that the resources and funding promised through NHS England’s GPFV reach GPs and practices working on the front line. As part of that assurance process we have implemented a system of monitoring feedback from LMCs regarding GPFV implementation in their local areas.
At present, our immediate priority is to ensure that the promised £16m resilience funding passes to practices by the end of March 2017. If you are a practice that should be receiving resilience funding support but are having difficulty doing so, I would urge you to please let your LMC know so that appropriate action can be taken on your behalf.
|GP health service
The NHS GP health service is a new confidential NHS service for GPs and GP trainees in England, launched on 31 January 2017 as part of the of GPFV. It will run in parallel to primary care performer occupational health services commissioned by CCG (clinical commissioning groups) under NHS England’s national service specification.
The NHS GP health service can help with issues relating to mental health, including stress, depression or addiction where these might affect a GP’s work. Operating on a self-referral basis, it is provided by health professionals specialising in mental health support to doctors and is available in various locations across England.
Access the service by emailing email@example.com or by calling 0300 0303 300. Availability is from 8am to 8pm Monday to Friday and 8am to 2pm Saturday. The service is not for emergency or crisis issues, which should be directed to mainstream NHS services.
We are pleased to welcome this service, and with it the implicit recognition of the massive stress and strain which hard-working GPs up and down the country continue to work under on a daily basis, and which is taking its toll on so many of our colleagues.
For further information about the service, visit the dedicated web page
|GP trainees work scheduling guidance
The GPC GP specialty trainee subcommittee, with the involvement of the BMA junior doctors committee, has worked with NHS Employers and COGPED (Committee of General Practice Education Directors) representatives to agree work scheduling guidance for juniors undertaking training rotations in GP settings.
This is an important development as it reinforces the existing important elements of the current COGPED/GPC guidance about GP training in the new junior doctors’ contract. See the guidance
Meet the team – Andrew Green
The GPC executive is supported by several GPC policy leads in developing and implementing strategy, and delivering our key responsibilities. In this issue, I would like to introduce you to Andrew Green – chair of GPC’s clinical and prescribing policy group.
Andrew is a partner in a rural dispensing practice in East Yorkshire, and has been on GPC for nine years and was chair of the clinical and prescribing subcommittee, which has now evolved to his policy lead role. He is a member of the RCGP’s over diagnosis group and has a particular interest in the measurement of quality in general practice and in patient safety. Recent work includes guidance on the care of patients with gender incongruence, and joint work with the BMA board of science on dependence on prescription medications.
‘An important part of my role is forming good personal relationships with bodies such as the RCGP and The National Institute for Health and Care Excellence,’ he said, ‘as that makes our fundamental message, that good working conditions for doctors enables good care for patients, easier to sell.’
He continued: ‘We need to abandon the idea that high-quality care involves doing everything for everyone, and instead do the right things for the right people; doing less, but doing it better. Inevitably that involves saying no to the things that are not worthwhile, or should be done by others.’
As to next year? ‘Priorities will include reviewing prescribing at the secondary/primary care interface, as we desperately need a system that is safe and works well for patients and doctors. There has also been much speculation about the future of QOF. If there are to be changes then we need to think very carefully about what good general practice looks like, and how we can demonstrate that we provide that, without creating new activity that takes us away from caring for our patients.’
General practice transformation champions – 7 March 2017
NHS England is hosting a free conference to inform and support those colleagues involved in supporting sustainability and transformation in general practice.
The event is free to attend for clinicians and managers in general practice and federations, as well as commissioners and providers of support to general practice.
You can find full details about the conference here
The solicitor will see you now: practice health checks from BMA Law
General practice is experiencing a significant period of change, and many practices feel they have no option but to hand back their core contracts as a result. If you are in this position, BMA Law can help. Its new practice health check service can help you evaluate the feasibility of taking this action, and understand your potential liabilities. Crucially, they can also review alternative solutions, to help you come to an informed decision. Find out more
Get more from your locum insurance with Lloyd & Whyte
Locum insurance pays your practice if you or a member of your team is unable to work owing to injury or illness. BMA members can get GP locum insurance that doesn’t require you to prove expenses, allowing you to pay for other expenses you incur. Get an online quote from our insurance partners today