BMA – Important Message to all GPs in  England on GP contract changes for 2017/18

BMA – Important Message to all GPs in England on GP contract changes for 2017/18

I am writing to let you know that GPC (general practitioners committee) England has concluded negotiations and reached agreement with NHS Employers on changes to the GP contract for 2017/18. In line with policy from the 2016 LMC conference and the views of GPs (sourced in part through our survey of the profession), our aim in these contract negotiations has been to: − provide stability to GMS/PMS contracts where possible − secure much needed funding to address GP practice expenses and increase core resources − tackle unnecessary bureaucratic workload, which takes vital time away from clinical care for our patients. We have fought hard for changes that we believe offer significant improvements to the contract and benefit and better support GPs and practice teams. While we welcome the positives secured in this agreement, the crisis facing general practice cannot be solved by contractual revisions alone. The crisis is largely a result of wider pressures outside our contract – with soaring demand, a critical shortage of GPs, inadequate NHS funding, excessive regulatory and bureaucratic burdens, and unresourced and inappropriate workload shift. We have therefore been in parallel discussions with NHS England and the Department of Health on tackling these wider issues, through ensuring that NHS England honours its commitments in the General Practice Forward View, as well as those we are taking forward through our Urgent Prescription. GMS contract changes for 2017/18 GPC England has overwhelmingly voted to accept the negotiated contract changes for 2017/18. A summary of the main agreed changes are as follows (for further details please visit our GP contract web page). AUA (Avoiding Unplanned Admissions) directed enhanced service We have negotiated that...
BMA – The new year demands a properly funded NHS

BMA – The new year demands a properly funded NHS

Happy new year to you – I hope you managed to get some well-earned rest during the festive period, before returning to the challenges of the year ahead.   We have entered 2017 with a health service overstretched well beyond capacity, which affects patients across the spectrum of GP surgeries, community services, hospitals and social care. Yet we also have a Government – borne out of a Brexit vote – unwilling to recognise this desperate need for more money, with the notable absence of any mention of the NHS in the chancellor’s Autumn Statement.   The prime minister continues to ignore the pleas for more funding from the Commons health select committee and NHS England chief executive Simon Stevens late last year, as well as from the Red Cross only last weekend. The BMA, alongside almost all other authoritative opinion, will lobby for this to be addressed in 2017 on the back of growing public awareness of the disconnect between political rhetoric and reality.   While media publicity has focused on hospital pressures, I have been emphatic that general practice is suffering under equal strain. I responded robustly in The Independent to the health secretary’s suggestion that the emergency care burden should be shifted to general practice. I highlighted that family doctors are already being worked ‘flat out’ and that ‘GP services are already overstretched and at full capacity, with one in three practices reporting doctor vacancies leaving many GP practices struggling to provide the necessary care to their patients’.   The crisis affecting general practice was restated in today’s National Audit Office report on access, which has highlighted...
BMA – Empowering patients to help themselves and us

BMA – Empowering patients to help themselves and us

This week – 14 to 20 November – is Self Care Week, which the BMA is very pleased to support.   Self-care is an obvious win-win for patients, GPs and the wider NHS. It empowers patients to take control of their own health and helps them to make informed decisions about which healthcare services they should access and when. Not only does it help patients feel more confident in managing their conditions, it also reduces the inconvenience and delay of unnecessary visits to their GP surgeries.   The BMA GPs committee believes that educating patients in self-care can play a vital role in reducing avoidable demand on GPs at a time of unprecedented pressures. This is why we secured a commitment from NHS England to consider developing a national programme of self-care as part of the 2016-17 contract agreement. Promoting self-care also forms a key recommendation in our Urgent Prescription for General Practice.   For the wider NHS, self-care enables overstretched NHS resources to be used appropriately and optimally for those patients in greatest need. A recent Dutch study published in the BMJ showed that two years after the launch of an evidence-based self-management website for patients, nationwide use of general practice decreased by 12 per cent.   The BMA Patient Liaison Group has produced some tips to help patients self-care through the winter months.   I strongly recommend the Self Care Forum, which has an excellent website with a range of resources such as guides, leaflets and posters available, which are easy to download. GP practices should put material on self-care in their waiting rooms, including electronic versions on...
BMA – The damaging double whammy of over-regulation and underfunding

BMA – The damaging double whammy of over-regulation and underfunding

The GMC published its annual report on the state of medical education and practice in the UK last week in which it spoke about a ‘state of unease in the medical profession’, highlighting:   A growing pressure on doctors A ‘dangerous level of alienation’ felt by doctors in training The impact struggling healthcare services are having on doctors’ education and training.   It is ironic that some of this is a direct result of disproportionate medical regulation in the UK, by which the GMC’s own processes have caused angst among doctors. GPs are further regulated by the CQC (Care Quality Commission), NHS England and performance managed by CCGs (clinical commissioning groups).   In last year’s BMA GPs survey, over-regulation was in the top five factors that negatively impact on GPs’ working lives, with 80 per cent stating that the CQC regime made them more likely to want to leave the profession.   This year’s GMC report speaks of the need for a ‘light-touch’ regulatory approach, but we have yet to see evidence of this. Equally, the CQC fees consultation proposes exorbitant increases in inspection fees (albeit to offset the loss of central government funding), when we would surely expect that a light-touch approach should signal a reduction in its operational costs. You can read the BMA GPs committee’s response, which strongly opposes these fee rises.   What the GMC report fails to point out is the shameful lack of NHS funding, lower than almost all of the UK’s Organisation for Economic Co-operation and Development counterparts, which puts pressure on doctors to do the impossible on scant resources – an environment in which, scandalously, nine out of 10...
BMA – Your chance to shape your future

BMA – Your chance to shape your future

  Last week I sent you an email launching our new general practice national survey for GPs in England, with a link to the survey.   If you have not yet completed the survey you can do so here   The survey can be completed on a computer or mobile device and should take about 15 to 20 minutes. Some functionality may be reduced on mobile devices but your answers will be recorded once you click ‘continue’ at the end of the survey.   Why have we launched this survey?   At a time when general practice is facing increasing and unprecedented workload pressures, a workforce crisis and inadequate resources, the BMA GPs committee wishes to hear from all GPs in England about how you would like to see general practice develop – and how it can best support your workload and future aspirations.   It is vital to design general practice around the needs of current and future GPs if we are to make general practice an attractive, rewarding and sustainable career option.   Who should complete it?   This important and comprehensive survey of GPs is aimed at all GPs in England, of all denominations including GP trainees.   We know that GPs have diverse career wishes, and even more so when stratified according to contract type or career stage. For example, the wishes of a newly qualified GP may differ from those approaching retirement; the perspective of a sessional GP may not be the same as a partner – and indeed the issues affecting salaried GPs may vary from that of freelance locums.   That’s why it’s...
BMA – How we can increase GP capacity now

BMA – How we can increase GP capacity now

I attended the Conservative Party conference on behalf of the BMA this week. Health secretary Jeremy Hunt announced plans to increase the number of UK medical students by 1,500 a year from 2018, and to introduce four years of mandatory service following graduation for junior doctors.   While increasing the number of medical students – and as a result trained UK medical graduates – is important, general practice needs immediate workforce support and increased capacity as of now. We simply don’t have the luxury of waiting the 10 years it takes from students entering medical schools to becoming GPs – assuming that is even their career choice.   Yet general practice capacity can in fact be increased currently, if we address the fundamental issue of unmanageable, excessive workload, which is driving one in five GPs to reduce their clinical sessions, which then reduces whole-time equivalent GP numbers.   Even more seriously, 38 per cent of GPs intend to quit in the next five years according to, Department of Health-commissioned figures, which means our priority must be to retain existing GPs, which can only happen if they feel valued and find their work manageable and professionally rewarding.   The induction and refresher scheme needs to ensure that those GPs who are not working, or those wishing to return to work in the UK, are able to do so rapidly and without having to jump through multiple bureaucratic hoops. We simply cannot afford to have highly skilled professionals sitting on the sidelines at a time when patient demand is rocketing. That is why we have worked with NHS England to simplify...