2024-25 GP contract referendum open – last chance to vote
GPC England voted unanimously to reject the derisory 1.9% 2024/25 GP contractual uplift and changes from the Government and NHS England. This is your opportunity to send a strong signal as to how the profession feels about the final contract and how we collectively move forward to protect the future of General Practice
The member referendum on the contract is now open and closes at midday on 27 March. You should by now have received an email from Civica with your unique voting link.
Watch a video of GPs committee chair Katie Bramall-Stainer discussing the GP contract referendum and last chance to vote – https://youtu.be/S4oPp0gRq8Q
Missing your ballot voting link?
There were some membership coding issues for a minority of members when the referendum opened.
However, if you are still missing your ballot, please follow the actions below:
Find out about the current contract changes and read our FAQs to learn what this means for you
If you have any questions about the referendum, please contact us on gpreferendum@bma.org.uk
How you vote will determine our next steps as a profession.
GPs see the equivalent of half the UK population every month.
| England general practice SOS ???? Over 1000 practices gone ???? 1,900 fewer full-time qualified GPs ???? Over 6,000,000 more patients on the books ???? Equivalent of 1:2 population seen EACH month ???? 400 million consults per annum ???? 5-6% of overall NHS funding spent on practice contracts ???? 5% of all NHS staff |
| We urge practices to continue to use our safe working guidance to limit contacts to 25 per day in order to prioritise safe patient care, within the present bounds of the GMS contract. |
Emergency motion at GPC UK on The Phoenix Partnership (TPP)
At its meeting last week, GPC UK debated and passed the following motion:
That this meeting is disgusted by the reported violent, openly racist and misogynistic comments made by Frank Hester, Director of The Phoenix Partnership (TPP), and directed at the Rt Hon Ms Diane Abbott MP, and:
i) notes that his comments contravene NHS England’s fit and proper person test framework introduced in response to the 2019 Kark Review recommendations, taking into account CQC requirements in relation to directors
ii) calls upon UK health boards to apply their own processes vigilantly when contracting external stakeholders whose views and values may not align with the wider professional national NHS workforce
iii) advises GP practices to consider Hester’s comments prior to signing new contracts with TPP
iv) believes Frank Hester should resign and handover his Directorship with immediate effect.
You can read more here.
GP Connect issue
Following recent reports that NHSE has been exploring using GP Connect as a means of centrally pulling patient data from practices, the BMA is seeking immediate clarification from relevant stakeholders. Data transferred via GP Connect is shared on the clear understanding that it is used for direct care. The deployment of the platform for any other purposes – including to circumvent GPs statutory role as data controllers, and access patient data for uses other than direct care is a clear contravention of the agreement put in place to use GP Connect.
Rebuild General Practice patient engagement toolkit
Rebuild General Practice has launched a patient engagement toolkit action pack containing ideas, tools and support available for Local Medical Committees (LMCs) and individual GPs wishing to engage with patients about the Rebuild General Practice campaign.
Watch the Rebuild General Practice patient engagement animation which can be downloaded to the screens of your surgery.
GP Registrars survey highlights increased levels of burnout and worries about future
A survey by the BMA’s GP Registrars Committee showed that qualified doctors who are training to become GPs in the UK are facing increased levels of burnout and are worried about their health prospects early in their careers.
In addition, under 10% of those who took part in the survey said they intend to work as a full-time GP, with just less than 20% stating that they feel confident of their future as a GP working in the UK.
Last chance for NHSE New to Practice GP and Nurse Fellowship sign up: deadline 31st March
NHSE recently announced the cessation of the NHSE GP and Nurse fellowship schemes
We would like to remind encourage those GPs eligible (within 12 months of CCT), to sign up for the programme in advance of the 31st March 2024 deadline. Please get in touch with your local Training Hubs for details regarding how to register.
Please also send any feedback on the scheme to info.gpc@bma.org
Annual flu letter
The tripartite annual flu letter for 2024/25 has now been published: National flu immunisation programme 2024 to 2025 letter - GOV.UK (www.gov.uk)
The letter sets out for providers the details of which cohorts are eligible for a flu vaccine in 2024/25 and which vaccines will be reimbursable. There are no changes to the cohorts for next year’s programme, but based on JCVI advice, there are changes to the timing of the adult programme.
NHSE will aim to publish the flu service specifications shortly.
Very high-risk breast screening
NHS England is currently contacting a group of 1,487 women at very high risk of breast cancer following chest radiotherapy for Hodgkin lymphoma, after NHSE was alerted that some of these women treated when aged between 10 to 35 years during 1962 to 2003 may not have been invited for this annual testing. NHSE has sent a letter apologising for what has happened and NHS breast screening services will follow up by offering appointments.
Anyone who thinks they might be in this group can get further information and support from a dedicated helpline: 0345 8778962
More information can be found on the NHS website
Guidance on conditions for which over-the-counter items should not routinely be prescribed
NHS England has published new guidance on conditions for which over the counter items should not be routinely prescribed in primary care: NHS England » Policy guidance: conditions for which over the counter items should not be routinely prescribed in primary care
GPC UK Regional Elections
The voting period is now open for seats to the General Practitioners Committee (GPC) in the following regions:
To submit your vote for any of the above seats please visit https://elections.bma.org.uk/ (The deadline for voting is 12pm Tuesday 26th March 2024).
Non-BMA members - You will need a BMA web account to access the election – you may already have one if you have registered for one to attend an LMC conference or if you have previously been a BMA member – if you think you have an account but are not sure please email elections@bma.org.uk with your GMC number and the team can check for you.
If you do not have an account, please contact support@bma.org.uk to let them know you need a web account to be able to participate in the GPC election. A member of the team will help you create an account and you will be assigned an BMA ID number, please email elections@bma.org.uk with this number and details of the region you wish to participate in. The team can then grant you access to the election.
If you have any queries regarding the election process, please contact elections@bma.org.uk.
Updating LMC contact details
A reminder for LMCs when updating any contact details, or any changes to personnel, to please email Karen Day kday@bma.org.uk.
GPC England committee pages and guidance for practices
Read more about the work of GPCE and practical guidance for GP practices. See the latest update on X @BMA_GP and read about BMA in the media. Contact us: info.GPC@bma.org.uk
Read the latest GPC England bulletin
2024-25 GP contract referendum – England
Join one of our webinars to find out more.
GPC England has rejected the 2024/25 GP contract changes. The contract has now been put to BMA GP members in a referendum. The referendum cannot prevent the Government from choosing to impose their changes to the contract, but it will send a strong signal as to how the profession feels about the contract, a potential third successive contractual imposition by Government and where we collectively go next.
Find out more about the current contract changes here.
You can watch Dr Katie Bramall-Stainer discussing the GP referendum here: GPC England contract referendum - YouTube
To ensure you can feel fully informed before you vote, we are holding a series of webinars and as we receive your feedback we will add FAQs to our webpage www.bma.org.uk/gpcontract early next week, which you can read and reflect on with your practice colleagues. As we receive more feedback, we will update the FAQs.
What to expect:
Webinar dates, times and Microsoft Teams joining links:
South East Coast: Wednesday 13th March - 19.30 - 21.00
North East: Wednesday 13th March - 19.30 - 21.00
North West: Thursday 14th March - 12.30 - 14.00
West Midlands: Tuesday 19th March - 19.30 - 21.00
South Central: Wednesday 20th March - 12.30 - 14.00
South West: Wednesday 20th March - 12.30 - 14.00
Yorkshire & Humber: Wednesday 20th March - 19:30 – 21:00
East of England: Wednesday 20th March - 19:30 – 21:00
National Catch-Up: Thursday 21st March
12.30 - 14.00 Microsoft Teams link
19.30 - 21.00 Microsoft Teams link
These webinars will NOT be recorded, so please attend your regional slot, or a national catch-up session. The referendum opened on 7 March and closes midday Wednesday 27 March. You should have received an email with a unique voting link.
How you vote will determine our next steps as a profession.
There are 48 more fully qualified, full-time equivalent GPs in January 2024 than in December 2023, marking seven months of sustained increases. However, we have the equivalent of 1,830 fewer fully qualified full time GPs than we did in September 2015. During this time, there has been a rise in the number of patients registered at practices, with January 2024 seeing another record-breaking rise. GPs are now responsible for 18% more patients than in 2015, creating ever mounting workload pressures.
An updated HRT PPC guidance document has been published by DHSC. This is to reflect changes to the definition of products in scope of the HRT PPC, following the launch of new products onto the market, and an agreed process for managing discontinuations. The latest version can be found here: HRT PPC guidance | NHSBSA.
Preparing for the Spring 2024 COVID-19 vaccination campaign
Preparations are underway for the Spring 2024 COVID-19 vaccination campaign, following the achievements of the 2023 Autumn campaigns. The NHS is focusing on delivering a seasonal COVID-19 vaccine dose, aligning with government recommendations. Eligible cohorts include adults aged 75 and over, care home residents, and immunosuppressed individuals. Efforts are being made to ensure equity in access and address variations in uptake. Funding and contract arrangements are extended to support vaccination activities, with plans for supply and delivery to be finalised soon. The commitment of healthcare professionals is crucial for the campaign's success. Read more here.
PRSB survey – GP activity data
The Professional Records & Standards Body (PRSB) are surveying GPs as part of a set of proposals to implement a standard set of SNOMED codes to capture consultation mode and GP activity data. The survey closes on 15th March and seeks to garner views from practices on how day-to-day activity that takes place can best be defined and recorded.
NIHR In-Practice Fellowship
The NIHR In-Practice Fellowship (IPF) initially offered academic training to fully qualified general practitioners, general dental practitioners, and community dentists, who are in NHS practice in England. The eligibility for this scheme has been broadened in 2024 to cover all other health and care professionals working in a primary care setting, including (but not restricted to) nurses, midwives, pharmacists and health visitors. This enhanced offer will enable a larger cohort of health and care professionals to access research training and development, to advance their academic research careers. In-Practice Fellowship (IPF) Round 18 | NIHR
Professional Record Standards Body
The PRSB is aligning its standards to the new Pathology standard (DAPB4101) going through approval at the DAPBin March. The current components used in PRSB standards were developed before the recent pathology standards. The PRSB need to ensure that test results and reports that clinicians receive can be shared digitally with their colleagues and can be incorporated into shared care records. The PRSB are asking clinical informaticians with an interest in pathology to review PRSB standards in light of the new standards to ensure that they align. To support this work, the PRSB are holding a webinar on Thursday 21 March, 11am - 1pm, to register click here.
GPC UK Regional Elections
The voting period is now open for seats to the General Practitioners Committee (GPC) in the following regions:
To submit your vote for any of the above seats please visit https://elections.bma.org.uk/
Non-BMA members - You will need a BMA web account to access the election – you may already have one if you have registered for one to attend an LMC conference or if you have previously been a BMA member – if you think you have an account but are not sure please email elections@bma.org.uk with your GMC number and the team can check for you.
If you do not have an account, please contact support@bma.org.uk to let them know you need a web account to be able to participate in the GPC election. A member of the team will help you create an account and you will be assigned an BMA ID number, please email elections@bma.org.uk with this number and details of the region you wish to participate in. The team can then grant you access to the election.
The deadline for voting is 12pm Tuesday 26th March 2024.
If you have any queries regarding the election process, please contact elections@bma.org.uk.
UK LMC Conference 23 and 24 May 2024 – Newport Wales
The deadline to register for the conference is Wednesday 1 May 2024. Please ensure that you have registered to attend as this is a registered only event. You can register here.
Updating LMC contact details
A reminder for LMCs when updating any contact details, or any changes to personnel, to please email Karen Day kday@bma.org.uk.
GPC England committee pages and guidance for practices
Read more about the work of GPCE and practical guidance for GP practices. See the latest update on X @BMA_GPand read about BMA in the media. Contact us: info.GPC@bma.org.uk
Read the latest GPC England bulletin
GP SOS - Save Our Surgeries
Have your say on the 2024/25 GP contract changes – join the BMA and update your details now
Following the unanimous rejection by GPC England of the contract offer on the table from government, GPCE’s officer team have reopened talks about the GMS contract changes for April 2024 onwards, giving the Government until the end of the month to present significant improvements. A letter has also been sent to the Chancellor of the Exchequer, Jeremy Hunt, outlining the perilous state of general practice and reminding him of his supportive words when he was chair of the Health & Social Care Select Committee. We are now waiting to hear back from NHSE and DHSC.
Whatever is on the table at that point will be put to you, as BMA members, via a referendum in March. This won’t stop the Government from imposing the contract changes, but it will give us a vital insight into how the profession feels about the contract, and where we go next. We know you need hope, stability and safety in your day to day-to-day work and in your surgeries and this is the message we give to government frequently and will continue to do so.
You need to be a BMA member to have your say in the referendum. This means making sure your details are up to date, and spreading the word to friends and colleagues about joining the BMA. We plan to open the referendum in early March, so do keep an eye on your email for the voting link. The email will be from Civica, which is handling the referendum on the BMA’s behalf.
To find out more about the current contract changes and why GPC England requested further changes, click here. I would urge you to watch and distribute the excellent video from Katie, our chair, explaining the perilous situation we face – you can find the video here.
General practice is in crisis. These figures are very revealing…
LMC guidance on IA
The team have updated our advice around what LMCs can legally do in times of industrial action and also in preparation for potential action. The advice does not discuss types of industrial action or timings as this will be discussed as progress is made. (see attachment – February 2024 - Advice to LMCs regarding preparatory activity relating to industrial action)
Workforce data
See more infographics and data showing the pressures in general practice >
We urge practices to continue to use our safe working guidance to limit contacts to 25 per day in order to prioritise safe patient care, within the present bounds of the GMS contract.
Cloud based telephony
GPCE has written to NHSE to raise concerns over the rollout of CBT (cloud-based telephony) and the financial and workload impact this is having on practices along with pressure to sign complex contracts on very short deadlines. NHSE advised last year that there would be no increased costs to practices for their monthly contracts. We have relayed concerns raised about these issues and are seeking an urgent meeting with NHSE while calling for a pause of the roll-out of this contract mandated procurement exercise.
We want to hear if you are seeing increased costs and please do email info.gpc@bma.org.uk with details of what you pay now and what you are being asked to pay going forward with the telephony provider.
GPs have been pressured at the last minute to sign up to new telephony systems at huge extra cost – despite reassurances from NHS England this would not be the case. Deputy chair Dr David Wrigley thinks this is a huge mistake and has called for an immediate pause, read more here.
Measles outbreak – practice staff and MMR vaccinations
This is an issue we are all facing in our practices, and we have been doing searches for patients who need vaccinating. We have written to NHSE asking for funding to do this additional work and pressed for negligence scheme cover. We can now advise that cover is in place and is outlined in the message below.
On behalf of Jane Freeguard, deputy Director of vaccination – medicines & pharmacy
In light of the national measles outbreak and urgency to support rapid uptake of the MMR vaccine, we are permitting practices to administer MMR vaccines to their eligible staff who are registered with another practice under INT (immediately necessary treatment). Please note this is a time limited arrangement until 31 March 2024 in light of the on-going national incident and only applies to MMR vaccinations.
An item of service fee cannot be claimed for the administration of MMR vaccines to staff registered with another practice. However, indemnity cover will be provided through CNSGP and nationally supplied MMR stock can be used to vaccinate eligible staff. Staff must be strongly encouraged to inform their registered practice that they have received an MMR vaccine, requesting it be included in their medical record.
UK LMC Conference 2024 - deadlines
The deadline for submitting motions for the UK LMC Conference is noon, 1 March 2024 - submit your motions here. The deadline for registration is 1 May 2024. Please note that even if you've booked your hotel you will still need to register for the conference here - although booking the hotel does not mean you are registered for conference.
For any questions, please email info.lmcconference@bma.org.uk.
GPC UK Regional Elections
Nominations are now open for seats to the General Practitioners Committee (GPC) UK in the following regions:
To be eligible to stand in a constituency, you must be a BMA member and one of the following:
To submit your nomination for any of the above seats please visit https://elections.bma.org.uk/ by the deadline 12pm, 4 March 2024. For any questions relating to the role or GPC please contact info.gpc@bma.org.uk and for any queries regarding the election process elections@bma.org.uk
A reminder for LMCs when updating any contact details, or any changes to personnel, to please email Karen Day kday@bma.org.uk.
GPC England committee pages and guidance for practices
Read more about the work of GPCE and practical guidance for GP practices. See the latest update on X @BMA_GPand read about BMA in the media. Contact us: info.GPC@bma.org.uk
Read the latest GPC England bulletin
GP contract 2024/25
GPC England has rejected the formal contract from the DHSC and NHS England (NHSE) for the General Medical Services (GMS) contract for 2024-25.
After consideration at its meeting on 1 February 2024, the committee unanimously voted that the current proposal, including a 1.9% uplift, is unacceptable. The committee was clear that in order to prevent practices from reducing services or closing down altogether, a contractual uplift sufficient to keep practice finances stable for the ‘stepping-stone’ contract year ahead is imperative. The proposal as it presently stands ignores the compelling evidence presented by the BMA GPC England officer team, which quantifies the attrition in the item of service fees for vaccs and imms; the reimbursements eligible under the SFE and the contract value since 2019. A contractual uplift of 1.9% to the global sum would also be disastrous for the employees of practices, including salaried and locum GPs and GP nurses.
Details of the contract come at a time when a BMA survey of 10% of practices in England found almost two in three (64%) report being concerned about their short and long-term viability, and more than half (57%) have experienced cashflow issues within the last 12 months. We had estimated that up to one in four GP surgeries would need to reduce their services to ensure they can remain open for patients, yet this was before this year’s derisory contract position and proposed below inflation funding uplift. GPC England was unanimous in providing us with a mandate to return to the DHSC, NHSE and ministers in Government to continue urgent talks ahead of a final position, which the profession will be asked to vote upon, in a referendum next month.
We’ve said from the beginning, our door will always be open to ministers and their teams. We’re willing to do all in our power to find a solution. As such, GPCE officers will now seek further discussions with the Government and NHS England to improve the GP contract to bring back hope, safety and stability to all GP practices across England.
Referendum and next steps
We have produced a webpage with everything you need to know about the current GP contract changes and what we plan to do next. Remember, whatever is on the table come March 1st will be put to you in a referendum which will enable the profession to decide whether the offer sufficiently supports general practice in England for the forthcoming financial year, or not. to decide whether the suggested changes sufficiently support general practice in England for the forthcoming financial year, or not.
To be eligible to vote in the referendum, you need to be a member of the BMA to have your say. This means making sure your details are up to date and spreading the word to colleagues about joining the BMA. The referendum won’t prevent the Government from imposing changes to the contract, but it will give us vital insight into how the profession feels, and where we go next.
Update your member details on www.bma.org.uk/my-bma and share this email with your colleagues and encourage them to join the BMA today to have your say. Visit our GP contract page here
Pharmacy First
Last Wednesday (31 January), NHS England launched the Pharmacy First initiative, whereby patients in England will be able to get treatment for seven common conditions at their high street pharmacy without needing to see a GP.
Community pharmacists can play an important role in delivering non-urgent basic care, which in theory can help reduce our incredibly busy workload as GPs. However, there are concerns that this scheme is being rolled out too quickly, and will rely on an inadequate IT infrastructure that will ultimately increase the administrative burden on practices, not lessen it. With almost 2,000 fewer fully qualified, full-time GPs than in 2015, this will put further pressure on a system already close to breaking point.
What patients want, and have always wanted, is the ability to access what they need from their local practice in a timely manner, and this must remain a priority. This remains in the Government's gift; we urge them to allow existing ringfenced funds, currently used to employ non-medical practitioners, to be used more flexibly so that practices can hire more GPs and nurses who are ideally placed to manage simple conditions.
GPCE letter to NHSE regarding the Measles outbreak
GPC England wrote to NHS England last week highlighting our serious concerns around the current Measles outbreak and the need for urgent support and resources in general practice.
The communications from NHSE and UKHSA show the lack of accompanying infrastructure, planning and resources to help address the outbreak within general practice. We have explained how the increase in workload generated by patient queries, requests for vaccination history cross-checking, and unresourced catch-up vaccination clinics, seriously risks impacting upon practice service delivery. We reiterated our request and belief that lowering the thresholds for vaccination QOF payments would enable greater coverage, rather than the current financially punitive approach that is in place.
We have requested an NHSE-mandated urgent rollout of time-limited packages of support for ICBs, and a Measles Vaccination Enhanced Service. The enhanced service would also cover the inherent costs to set-up and staff necessary clinics to limit the impact on normal day-to-day care.
The letter was also shared in a meeting with the parliamentary under-secretary for primary care, Andrea Leadsom.
GPC England Response to The Times Health Commission report
The Times Health Commission report was published this week, making some key recommendations for immediate future NHS commissioning, with a lot of attention focused on how IT and data isn’t able to link up across NHS organisations. A seductive vision of all shared health and care records and data in one place sounds good, but fundamental missing steps along the way risk making that distant dream an impossibility.
To free up millions of appointments, we need hospitals to be able to produce electronic prescriptions, and to be able to explain to a patient where they are in a queue after disappearing down a referral ‘black hole.’ Hospitals should be following a patient; the same way online shopping follows a parcel.
Those of us working on the ‘shop floor’ of the NHS, stand ready to suggest many practical ways to improve financial efficiency and operational productivity (that won’t cost us millions to implement) but which will need genuine integrated thinking outside of the acute hospital model. This is what we need, which we are glad to see recognised in this report.
The elephant in the room is resource, and we note difficult requests for detailed capital investment requirements are not outlined, which is a missed opportunity. GPC England believes that the million patients which GPs see every day recognise that if we are to make any progress, we need additional funds for additional activity, serving additional patients. We also need to recognise the forgotten millions on mental health waiting lists who aren’t included in media headlines but who GP and community teams feel are being ignored, especially children and adolescent mental health need.
Access to records – ICO response to DPIAs
Following DPIAs being submitted by many practices relating to the accelerated access to records programme, the ICO (Information Commissioner’s Office) this is a reminder that the ICO published its advice last month. The ICO is content that ‘potential data protection risks have been identified, and that sufficient mitigations are in place.’ Practices that haven't completed a DPIA are encouraged to do so and make their commissioners aware. If practices identify particular data protection risks associated with providing online access, which they do not consider to be mitigated, they should consult and engage with the ICO and their commissioner to find a way forward.
The ICO is technically correct that in theory, a practice could expend whatever infinite resource it wished in order to comply with the contractual requirement to give access. Because a practice could theoretically mitigate (at enormous cost) the ICO is content that the Data Protection Act will not be broken.
It's what the ICO has not said which is telling. Reading between these lines, one may infer that if mitigations were not in place (i.e. access was blanket switched-on, as may have happened in many cases) there may be questions over the legality. Hence the BMA's advice is that as a practice you must still construct a DPIA and keep your commissioners updated. If you are facing local issues, let us know and be sure to include your LMC in such discussions.
Workforce data
Our BMA teams collate monthly workforce and appointment data on the pressures in general practice data analysis webpage, which is a great resource for signposting PPGs, local press and MPs.
The overall number of GPs has seen little growth since 2015, with the number of GP partners declining significantly over that time. As of December 2023, there were 37,068 fully qualified GPs working in the NHS in England, with around 7.8 GPs per 10,000 people, and would need an additional 16,700 GPs to be on equal footing with the OECD average of 10.8.
Despite the Government’s promise to recruit an additional 6,000 GPs by 2024 to reverse the stasis in GP workforce numbers, there are now the equivalent of 1,877 fewer fully qualified full-time GPs compared to September 2015.
See more infographics and data showing the pressures in general practice >
We urge practices to continue to use our safe working guidance to limit contacts to 25 per day in order to prioritise safe patient care, within the present bounds of the GMS contract.
COVID-19 vaccination programme update
NHS England have published an extension to the COVID vaccination service specification ahead of the proposed spring/summer booster programme. The specification remains mostly unchanged from the current Autumn/Winter programme, however, following discussions with GPC England, there will be an additional £2.50 payment per vaccination for vaccinations from April-August 2024, in addition to the £7.54 Item of Service fee. Whilst this move is welcome, we retain strong concerns about the future financial viability of the programme, and we again recommend that practices and their partners make a full assessment of whether delivery of the vaccination programme remains viable for them.
Cloud based telephony
GPCE has written to NHSE to raise concerns over the rollout of CBT (cloud-based telephony) and the financial and workload impact this is having on practices along with pressure to sign complex contracts on very short deadlines. NHSE advised last year that there would be no increased costs to practices for their monthly contracts. We have relayed concerns raised about these issues and are seeking an urgent meeting with NHSE while calling for a pause of the roll-out of this contract mandated procurement exercise.
Tweet your MP and local 2024 general election candidates about #WhyCantISeeMyGP
A new book by Cumbria LMC member Dr Ellen Welch highlights the crisis facing general practice today. is already listed as a best seller on Amazon and is being reprinted. Dr Welch said: “This book shines a light on how general practice holds the NHS together. We urge anyone with a stake in the NHS – staff, patients, leaders – to take a read. If general practice fails, the NHS fails so we need both understanding and investment from our government.”
The book is full of personal accounts from GP leaders including GPC England deputy chair Dr David Wrigley. Katie Bramall-Stainer, chair of GPC England, said: “As the saying goes, ‘you don’t know what you’ve got ’til it’s gone’. Thankfully this book presents us with solutions, and I gifted an advance copy to Minister Leadsom for Christmas!”
Please use the resources on this page to write to your MP and spread the word on social media.
BMA divisional elections
Elections are taking place within BMA divisions to choose local representatives to attend the BMA 2024 ARM (annual representative meeting). The ARM debates important policy issues that affect the whole profession and conducts elections to many BMA committees, so a strong GP voice and influence is important. All GP colleagues are encouraged to review the local nominated candidates in their divisions and vote accordingly. Voting closes noon, 13 February. Access the election portal >
GPC UK Regional Elections
Nominations are now open for seats to the General Practitioners Committee (GPC) UK in the following regions:
To be eligible to stand in a constituency, you must be a BMA member and one of the following:
To submit your nomination for any of the above seats please visit https://elections.bma.org.uk/ by the deadline 12pm, 4 March 2024. For any questions relating to the role or GPC please contact info.gpc@bma.org.uk and for any queries regarding the election process elections@bma.org.uk
LMC Secretaries Conference 2024
The LMC secretaries conference is taking place on Friday 15 March 2024 at BMA House in London. To register to attend please use the online application form available here, each person attending the conference must register by completing a registration form regardless of how they are planning to attend i.e. first, second or observer, the closing date for registration is 23 February 2024.
Please contact the GPC office at info.lmcconference@bma.org.uk with any queries.
UK LMC Conference 2024 - deadlines
The deadline for submitting motions for the UK LMC Conference is noon, 1 March 2024 - submit your motions here. The deadline for registration is 1 May 2024. Please note that even if you've booked your hotel you will still need to register for the conference here - although booking the hotel does not mean you are registered for conference.
For any questions, please email info.lmcconference@bma.org.uk.
Updating LMC contact details
A reminder for LMCs when updating any contact details, or any changes to personnel, to please email Karen Day kday@bma.org.uk.
GPC England committee pages and guidance for practices
Read more about the work of GPCE and practical guidance for GP practices. See the latest update on X @BMA_GP and read about BMA in the media. Contact us: info.GPC@bma.org.uk
Read the latest GPC England bulletin
Read the latest sessional GPs newsletter
Referendum of the GP 2024/25 Contract – Join the BMA today and have your say
Your national team are anticipating a final contract proposal for 2024/25 from the DHSC (Department of Health and Social Care), together with NHSE (NHS England) to arrive later today – Friday 26 January. Your national committee, GPC England, will be meeting to fully consider this offer next week, on Thursday 1 February. In line with LMC conference policy, we are preparing to hold a referendum which will enable colleagues to decide whether the offer sufficiently supports general practice in England for the forthcoming financial year, or not.
To be eligible to vote in the referendum, you need to be an NHS GP, practising in England, and a BMA member. You can join the BMA here. We will be writing to you again the week after GPCE meets with more details.
We recognise that the Government can still choose to impose a contract, regardless of a referendum outcome. It will, however, provide a vital temperature check of the profession which we can then share with ministers, the Department of Health and Social Care and NHS England.
Whether GPC England feels able to recommend the contract offer for 2024/25 will depend on whether it fulfils its promise to be a sufficiently stabilising ‘stepping stone’ contract following the end of the 2019-24 multi-year contract framework and PCN DES. We have been clear with the Department and NHS England that the 2024/25 contract must bring hope for the future and return confidence to our profession; allow practices to feel safe in delivering a sustainable service; deliver safe care for patients; and permit a safe working environment within which they can recruit and retain GPs and the wider essential practice team.
There are no surprises here, for context in Spring 2023, GPC England voted to prepare to ballot GPs on taking collective action if the Government did not ‘drastically improve the contract’ in these negotiations. With those discussions now reaching their conclusion, GPC England and the profession have important decisions to make. If there is no positive outcome to current talks with ministers, DHSC and NHSE, the spectre of GP collective action in 2024 remains.
If you are a GP member practising in England within the NHS, make sure the details we hold for you are up to date to ensure your vote counts. Tell your partners, colleagues, peers and friends. Update your member details on www.bma.org.uk/my-bma share this email or join us as a member today.
Ensure everyone has a voice – please encourage your colleagues to join the BMA.
Medical Examiners’ arrangements and changes in the Medical Certificate of Cause of Death
Colleagues will recall the ultimately postponed March 2023 introduction of the Medical Examiner (ME) scrutiny of non-coronial deaths in the community; this is now planned to be implemented in April 2024.
Regrettably there is no consistency within the England wide rollout; instead, ME units have been asked to form geographically appropriate links with local GP practices; this then means each practice should know where the deceased’s details, including medical records and the proposed MCCD (Medical Certificate of Cause of Death), should be sent. If a GP wishes to report a death to the coroner instead, they can still do so but increasingly it is likely the coroner’s office may ask if this referral has been discussed with the medical examiner first.
The purpose of the ME scrutiny is to:
The ME can contact the GP who has written the proposed MCCD to discuss this, or any information in the medical records. If all goes smoothly, the ME will confirm the proposed MCCD with the Registrar, GP practice, and a person who can act as the informant in terms of registering the death – normally a family member of the deceased.
The ‘attending practitioner’ will remain responsible for completing the MCCD, although there is now provision for a GP not being available, as in exceptional circumstances the ME can write a MCCD. If the ME and attending GP cannot agree on the cause of death, the matter will be referred to the Coroner.
To complement the ME arrangements, a new paper MCCD will be available from April 2024, with an online version promised later this year. This will include:
The current Crematorium Form 4, and the private fee payable, is being abolished. Based on feedback so far, GPC England has the following concerns:
GPC England recommends LMCs ask all practices to confirm their links with local ME units and to test the system for reliability and administrative burden. GPC England has written to the National Medical Examiner to highlight these continuing concerns.
EMIS and coding problems for QOF
The Joint GP IT committee (with representatives from GPC England and RCGP) met last week. EMIS had been invited to speak following concerns raised by members about QOF/coding problems and medications missing from data sets following EMIS updates MKB 203, MKB 204 and MKB 205. EMIS is aware of these issues and apologised for them. They assured the committee they have been working to resolve them.
EMIS plan to release MKB 206 by the end of January to remedy the issues caused by previous updates. Once MKB 206 has been released, if you continue to run into problems, please do get in touch so we can collate concerns and share these with EMIS and resolve any further issues email: info.gpc@bma.org.uk. We recognise this has had an impact on your QOF work in this critical time running up to April and we have made EMIS aware of the seriousness of the situation for hard-pressed colleagues.
Access to Records – ICO response to DPIAs
Following submission by many practices of their DPIAs (Data Protection Impact Assessments) relating to the accelerated access to records programme, the ICO (Information Commissioner’s Office) has decided to publish its advice ‘so GPs affected are aware of the ICO’s views on the matter.’ Read the advice >
The ICO is content that ‘potential data protection risks have been identified, and that sufficient mitigations are in place.’ Practices that haven't completed a DPIA are encouraged to do so and make their commissioners aware. If practices identify particular data protection risks associated with providing online access, which they do not consider to be mitigated, they should consult and engage with the ICO and their commissioner to find a way forward.
GP end of year forms: submission deadline extended to 31 March
All Type 1 and Type 2 practitioners must complete the relevant certificate or form and submit to Primary Care Support England (PCSE) for work in England, or their local Health Board for work in Wales.
The release of both they Type 1 and Type 2 forms was delayed this year, and as a result the deadline for submitting these has been extended to 31 March 2024.
BMA divisional elections
Elections are now taking place within BMA divisions to choose local representatives to attend the BMA 2024 ARM (annual representative meeting). The BMA ARM debates and develops important policy issues that affect the whole profession, it also conducts elections to many of the BMA’s committees, so a strong GP voice and influence is important. All GP colleagues are encouraged to review the local nominated candidates in their divisions and vote accordingly.
You can access the BMA election portal here (BMA members only) and click on “Online elections”:
NHSE GP Fellowship Scheme cessation
NHSE has announced that the NHSE GP Fellowships and Mentor schemes will end on 31 March 2024.
We would like to remind and encourage those GPs who are within 24 months of having CCT’d on 31 March, and who have not yet taken advantage of the NHS GP Fellowship Scheme, to sign up for the programme in advance of the 31 March deadline. Those successful in securing a place ahead of the deadline will have funding secured for two years. Please get in touch with your local Training Hubs for details regarding how to register. Please share this information across your trainers and First 5 groups. Please also send any feedback on the programmes to info.gpc@bma.org.uk
Rebuild General Practice – template letter to MPs
Rebuild General Practice is asking GPs to use its template letter to write to your local MP asking them to prioritise rebuilding general practice in their election roadmaps. Party manifestos are being written this spring, and we can make a difference by speaking as one unified voice and profession, to engage MPs, and local press. We must ensure that all major parties are motivated to prioritise the crisis in general practice and are committed to developing plans to do so following the election.
Find all the materials you need to take part in this action here
2. Share the social media thread: https://twitter.com/RebuildGP/status/1750131367575204082
3. Write to your local newspaper editor to inform them of this action.
4. Encourage your colleagues to do the same by sharing your post and the materials with them.
UK LMC Conference – deadlines
The deadline for UK LMC conference registration is 1 May 2024. Please note that even if you've booked your hotel you will still need to register for the conference via https://events.bma.org.uk/uk-conference-of-lmcs-2024/registration - although note that booking the hotel does not mean you are registered for conference.
The deadline for submitting conference motions is noon, 1 March 2024. You can submit your motions here.
Any questions regarding registration and submission of motions please email info.lmcconference@bma.org.uk.
Extension of services for GP partners
For GP partners who are BMA members, we provide HR and employment law advice for you or your delegate. The BMA Employer Advisory Service is now offering a valuable extension of its services under the EAS: GP Enhanced Services Pilot. In addition to providing HR and employment law advice to GP practices through the BMA’s GP partner membership, we are delighted to offer:
Please contact the BMA on 0300 123 1233, or email support@bma.org.uk.
*excluding those involving employed/locum doctors.
Wellbeing resources
We continue to encourage practices to focus on their own team’s wellbeing and take time to reflect on what can be done to protect it (this will also meet the requirements of QOF quality improvement project on staff wellbeing). We have produced a document which includes some tools for improving workload and safe working. A range of wellbeing and support services are also available to doctors, from the BMA’s counselling and peer support services, NHS practitioner health service, Samaritans and Doctors in Distress. See also our poster with 10 tips to help maintain and support wellbeing.
GPC England committee pages and guidance for practices
Read more about the work of GPCE and practical guidance for GP practices. See the latest update on X @BMA_GP and read about BMA in the media. Contact us: info.GPC@bma.org.uk
Read the latest GPC England bulletin
Have your say now on the future of general practice - COMPLETE OUR SURVEY
We know how busy you all are - but we need your help, and we need to hear your voice.
2024 marks both the 20th anniversary of the introduction of the 2004 GMS contract, and the end of the current 2019-24 five-year investment framework. A general election is also likely later this year, and potentially, a new Government.
With change comes opportunity, and a window to influence how we deliver patient care now, and for the years ahead.
As your representatives, we are keen to feed your views into our strategy to help influence the future direction of General Practice. We will be articulating our vision outlining the direction we need to see for our patients, profession and practices determined by those who know it best: GPs themselves.
This is where you come in. We want to give you a voice.
The next 6-12 months are key, and we need to make the most of this window of opportunity to influence, shape and inform the future.
If you only respond to one survey, make it this one.
We want to hear from all fully qualified GPs an ST3/4 GP Registrars in England, including non-BMA members.
The survey will close on Sunday 21 January 2024 but please complete it as soon as you're able.
Share the survey via WhatsApp with all your GP colleagues now
Preparation for any future ballot
We need our GP contract to feel safe to sustain services and deliver for our patients. We need our workload to feel safe to retain and recruit GPs and the wider practice workforce. We have been clear with DHSC and NHSE that 2024/25 must bring hope for the future of our profession. This is also the will of GPC England, who in April 2023 voted to prepare to ballot GPs on taking collective action if the Government does not “drastically improve the contract” in 2024/25 negotiations.
At the England Conference of LMCs 2023, Conference also voted to take the outcome of future contract negotiations to the profession. Tell your colleagues and partners to join the BMA today.
Death certfication reforms
The government has confirmed that the death certification reforms will be enacted from April 2024, including the role of the medical examiner (ME) becoming statutory. Once the new death certification process comes into force, all deaths in England and Wales will be independently reviewed by a medical examiner or a coroner. The main changes:
· NHS trusts hosting a medical examiner office should provide adequate support and ensure the independence of medical examiners is respected.
· All other healthcare providers including GP practices should set up processes to start referring deaths to medical examiner offices if they have not already done so. There is a podcast on how medical examiners can support GPs and their work with bereaved people.
· Integrated Care Boards (ICBs) in England should ask all healthcare providers in their area to establish processes to refer relevant deaths to medical examiner offices for independent scrutiny as soon as possible.
Other changes including a new Medical Certificate of Cause of Death, which can be completed by a doctor who attended the deceased at any time (at present MCCDs can only be completed if the doctor saw the patient within 28 days before death or after death). Read more here
GP pressures and workforce data
Our BMA teams collate monthly appointment and workforce data onto our website, which is a great resource for signposting PPGs, local press and MPs. November 2023’s data shows that the NHS in England has 1,881 fewer fully qualified FTE GPs than we did in September 2015. The number of GP practices in England has also decreased by 112 over the past year – reflecting a continued trend of closures as well as mergers primarily due to a lack of workforce that coincides with a rise in patients.
Around 31.5 million appointments were booked in November 2023, with an average of 1.43 million appointments being delivered per working day, which is above the average of 1.39 million per day for the past year. In addition, as of November 2023, there was another record-high of 63.03 million patients registered in England, with an average of 9,977 patients registered per practice. A single full-time GP is now responsible for around 2,300 patients – an increase of 18% since September 2015, demonstrating the ever-mounting workload in general practice.
Click here for more infographics and data on showing the pressures in General Practice.
We urge practices to continue to use our safe working guidance to limit contacts to 25 per day in order to prioritise safe patient care, within the present bounds of the GMS contract.
Sessional GPs locum work challenges
The Sessional GPs Committee continue to hear increasing reports from our constituents that they are struggling to find locum work in practices. Practice finance pressures as highlighted in our recent practice finance survey and the need to use.
ARRS funded (which exclude GPs) has resulted in a huge reduction in available locum shifts, leaving many GPs unable to work.
We have raised these concerns face to face with NHSE and DHSC and, via the GP wide survey, are gathering increasing evidence of this issue. We will continue to lobby for the inclusion of GPs (and practice nurses) in the ARRS. Patients want and deserve to see a GP and at a time when we have a supposed shortage of GPs it is unconscionable that anyone should be struggling to find employment or that patients are denied the benefits of the skills and expertise those GPs have spent their entire careers developing.
It is GPC England’s view that it would be appropriate to include General Practitioners (and Practice Nurses) as reimbursable roles within the ARRS programme. Had the considerable financial support associated with the ARRS programme over the past five years been directly available to General Practitioners for use within their practices, without the constraints on recruitment associated with the PCN DES specification, this would have created a far more flexible, responsive and sustainable solution to the workforce crisis facing General Practice. We also believe this would have resulted in better value for money from ARRS funding in terms of patient care.
Without the necessary support that General Practice so desperately needs from NHSE/DHS, in order to provide safe, effective and efficient care to its patients, we can expect to see further losses of GPs from the NHS, and from England to elsewhere with a consequent continued erosion in the standards and quality of care provided.
Online access to records - data breaches from misfiling of records
There is ongoing work continuing behind the scenes focusing on making the online access to records project safer. Our outstanding concerns regarding how this was imposed on the profession can be found here.
If you have any examples of potential or actual harm that has arisen, for example: the accidental misfiling of data/letters in the wrong patient's record, or when information should have been withheld from online view in order to prevent harm, but wasn't, and which has only come to light now more patients have access to their records, please pass on details to info.gpc@bma.org.uk.
Direct access to diagnostic tests
NHSE has published ‘Enhancing GP direct access to diagnostic tests for patients with suspected chronic obstructive pulmonary disease, asthma, or heart failure’. This is non-clinical guidance for systems which should be helpful for LMCs in local discussions about availability of Spirometry, FENO and NT-proBNP. It is clear that commissioners should continue with local services where they exist but that additional services should also be in place, which must be made available for GP referral via eRS.
NHSE has been explicit that they are not the commissioner of these services and decisions on exactly what is commissioned rests with local ICBs. This guidance confirms that these services should be made available for all GPs to refer to, therefore clarifying that practices should not be expected to provide, unless appropriate funding is in place.
Lipid modification resource implications
GPCE, along with RCGP, met several times with NICE about ‘Cardiovascular disease: risk assessment and reduction, including lipid modification’. LMCs have raised concerns about QOF targets and the resource implications of providing alternative lipid lowering agents such as ezetimibe, Inclisiran and PCSK9 inhibitors.
As a result of these meetings, NICE reviewed its Resource assessment, which recognises the additional costs and demand on GP appointments associated with prescribing and administration of Inclisiran; and that PCSK9 inhibitor prescribing is mainly hospital based and likely to remain low. As these services will be commissioned locally and NICE has produced a template for ICBs to assess local resource implications, which includes the additional GP appointments likely to be required. The NICE guidance committee stated that ‘increased uptake of lipid-lowering treatments is necessary for an overall improvement in population health, but that the extra cost of lipid-lowering treatment would be partly offset by savings due to a reduction in CVD events (including hospital admissions for stroke, heart disease and cardiovascular procedures).’ Therefore we would encourage LMCs to utilise this is local negotiations when ICB medicines committees are considering General practice provision of Inclisiran and PSCK9 inhibitors, and for the negotiation of Locally Commissioned Services to provide Inclisiran.
King’s New Year Honours
We are delighted that the following GPs have been recognised in the King’s New Year Honours list:
Congratulations to all on receiving these much-deserved awards.
NHS Vaccination Strategy
In December NHS England announced their long delayed ‘vaccination strategy’, following an initial consultation in 2022. The strategy aims to support and boost vaccination rates in England. GPC England will be discussing its approach to this and what it means for General Practice over the coming months. when it meets on February 1st. We shall respond in the coming weeks once 2024-25 contract negotiations have concluded.
DDRB Evidence submission for GPs across England
BMA Council took a decision in November to undertake a referendum of divisions on ARM policy following a motion from GPC England chair and BMA Council member for Eastern Region, Katie Bramall-Stainer. This led to BMA Divisions being invited to hold division meetings and vote afresh on the policy in line with Articles 69 and 70 of the articles and bye-laws of the Association.
22 Divisions participated in the referendum and a total of 135 votes were received. There was an overwhelming vote to overturn the existing policy, which has now been removed from the policy book, and all committees, including GPC England are now able to submit evidence to the DDRB. Our thanks to all the honorary secretaries of those divisions who went out of their way to arrange meetings.
MAPs to be regulated by the GMC - write to your MP
The Government has announced that physician associates and anaesthesia associates are to be regulated by the GMC. The BMA thinks that this will add further, dangerous confusion and we need every MP to be aware of this issue, oppose the legislation and force the Government to abandon its plans. Please help by using our tool to email your MP.
LMC Secretaries Conference
The LMC secretaries conference is taking place on Friday 15 March 2024 at BMA House London. To register to attend please use the online application form available here, each person attending the conference must register by completing a registration form regardless of how they are planning to attend i.e. first, second or observer, the closing date for registration is 23 February 2024.
Please contact the GPC office at info.lmcconference@bma.org.uk with any queries.
LMC England Conference 2023
Watch a recording of the Annual Conference of England LMCs 2023, held on 23-24 November 2023:
Day 1: Bma Live Stream (streameventlive.com)
Day 2: https://bma.streameventlive.com/archive/323
Read more about the event, including the resolutions, here: Local medical committees (bma.org.uk)
BMA Annual Representatives Meeting 24 –25 June 2024
Calling all GPs to self-nominate for the ARM (annual representatives meeting) which considers important policy that affects the whole profession.
The RB (representative body) is made up of constituent bodies that sends elected representatives to the ARM each year to debate on and pass new BMA policies. It also conducts various elections, considers reports from council, the board, and committees.
We’d like a strong GP presence, so please put yourself forward!
Deadline to nominate is 19 January 2024 via this link
Wellbeing resources
We continue to encourage practices to focus on their own team’s wellbeing and take time to reflect on what can be done to protect it (this will also meet the requirements of QOF quality improvement project on staff wellbeing). We have produced a document which includes some tools for improving workload and safe working. A range of wellbeing and support services are also available to doctors, from the BMA’s counselling and peer support services, NHS practitioner health service, Samaritans and Doctors in Distress. See also our poster with 10 tips to help maintain and support wellbeing.
GPC England committee pages and guidance for practices
Read more about the work of GPCE and practical guidance for GP practices. See the latest update on X @BMA_GP and read about BMA in the media. Contact us: info.GPC@bma.org.uk
Read the latest GPC England bulletin
Have your say on the future of general practice - COMPLETE OUR SURVEY
We are at a pivotal point for the profession. We are all struggling with workload pressures and have inadequate resources to run our practices and deal with our patients. Over 7 million patients are now on waiting lists which were huge even before the pandemic hit us. That has a knock-on impact for our working day as patients seek our help as they wait longer and longer for treatment. The funding we receive in general practice is wholly inadequate at around 8% of the NHS budget. We need much more investment and will continue to push for this.
We are currently engaged in discussions with NHSE and DHSC about our contractual changes for April 2024 and have our minds set on the bigger picture of what comes after that for the profession. With a General Election getting even closer we are meeting with opposition politicians to outline what we need in general practice to make our service fit for the future.
This is why we want to give you a voice. We have put together a profession wide survey which will inform the work ahead of us and tell us what you need as GPs for the coming years. Your views are vital and will be used to inform our work going forwards. You don’t need to be a BMA member to complete the survey.
PLEASE DISTRIBUTE THE LINK & COMPLETE OUR SURVEY – https://www.research.net/r/bmagp23
If you only respond to one survey, make it this one.
We want to hear from all fully qualified GPs in England, including GP Registrars at ST3 and above, whether you’re a BMA member or not.
The survey will close on Sunday 21 January 2024 but please complete it as soon as you can.
Share the survey via WhatsApp with ALL your GP colleagues: https://tinyurl.com/GPSurveyShare
GP finance survey
With the 2024/25 negotiations ongoing – we are asking all practice managers in England to complete the GPC England’s finance survey. You will have seen our survey on the future of general practice, above; now this is your opportunity to demonstrate the increasing impact of inflation and rising costs on English GP practices over the past 12 months. It’s vital for us to hear about the challenges you face with practice finances and what we all need to help support the service we provide.
You will need the practice’s set of GP accounts for 2021/22 and 2022/23, as well as expenditure data for the months of October 2022 and October 2023 together with information on how many staff the practice employs. The survey should take 20-30 minutes to complete and closes midnight, 3 January 2024. Please send any other feedback to gpsurvey@bma.org.uk
We urge practices to continue to use our safe working guidance to limit contacts to 25 per day in order to prioritise safe patient care, within the present bounds of the GMS contract.
Inclisiran
There are still widespread concerns with the manner and speed with which NHS England have attempted to push Inclisiran, which is a black triangle injectable drug. There are still a number of questions, raised by both GPCE and the RCGP, on which NHS England has yet to provide a satisfactory response, and this was set out in our joint position statement with the RCGP.
We would like to remind practices that the prescription or administration of Inclisiran is not part of the GMS/PMS contract (although in negotiation with the LMC it may be commissioned via a LES). The onus lies with Commissioners to commission an appropriately funded service if they wish patients to have access to this drug, either within General Practice or via Specialist services.
Online access to records - data breaches from misfiling of records
We continue to work on this topic and seek to make the whole project fit for purpose. We have had numerous concerns about how this was imposed on the profession and these can be found here.
If you have any examples of potential or actual harm that has arisen from the accidental misfiling of data/letters in the wrong patient's record, or when information should have been withheld from online view in order to prevent harm, but wasn't, and which has only come to light now more patients have access to their records, please pass on details to info.gpc@bma.org.uk.
NHSE guidance on DHSC funding for non-consolidated pay awards
Please note that this process is being managed by NHSE. They have confirmed it is for individual providers to determine whether they may be eligible to claim, and their guidance – published on 27 November – includes details on how to do this and the necessary forms for completion.
Funding is available to support non-consolidated pay awards in organisations in relevant circumstances. DHSC (Department of Health and Social Care) is seeking to only intervene to the extent that organisations are considered unable to cover the costs of the pay award without it negatively impacting on the continuity of services.
To meet the stated criteria, these circumstances should be demonstrated in reference to the risk assessment framework and reporting manual for independent sector providers of NHS services (IPRAF). Individual providers may need to seek independent financial advice to ensure they meet the criteria, and to support the completion of section 3 (relevant circumstances) of the submission form.
Requests are required to be sent to england.ncpayments@nhs.net and must be sent no later than Friday 15 December 2023. We understand requests received after this date will not be considered.
MAPs to be regulated by the GMC - write to your MP
The Government has announced that physician associates and anaesthesia associates are to be regulated by the GMC. The BMA thinks that this will add further, dangerous confusion and we need every MP to be aware of this issue, oppose the legislation and force the Government to abandon its plans. Please help by using our tool to email your MP. Read also the statement in response by Prof Philip Banfield, BMA chair of council, to the announcement.
Afghan relocation programme - ICB funding
In a recent communication, NHS England has reminded ICBs to work with local authorities to identify and support the healthcare needs of people relocating under the Afghan Relocation programmes. ICBs should use the recommended health screen for new arrivals and can claim funding directly from the Home Office for the first year of healthcare for those in settled accommodation.
Annual Conference of Representatives of LMCs (UK) 2024
The next UK Conference LMCs is due to take place on 23-24 May 2024 and will be held in Newport at Celtic Manor Resort. Motions should be submitted via this link and the deadline is noon, 1 March 2024. Representatives shall be registered medical practitioners appointed by the appropriate LMC, and LMCs are asked to complete the registration form by the following link no later than 1 May 2024
We would also like to draw your attention to the arrangements for booking accommodation for this conference. Hotel rates are available at the priority booking website. Guests can also book by telephoning PRIORITY on 0845 6123 611 or +44 1473 550 620 and quoting Event Code: BMAA008 24
For more information please refer to the letter from the Conference Chair which has been emailed out to LMCs. If you have any other questions, please email info.lmcconference@bma.org.uk
Cameron Fund Christmas Appeal 2023
The Cameron Fund is the GPs' own charity and it is the only medical benevolent fund that solelysupports GPs and their dependents. The fund relies on donations from members and Local Medical Committees. Read more about how to donate in the Cameron Fund Christmas Appeal letter.
Preparation for any future ballot
We need our GP contract to feel safe to sustain services and deliver for our patients. We need our workload to feel safe to retain and recruit GPs and the wider practice workforce. We have been clear with DHSC and NHSE that 2024/25 must bring hope for the future of our profession. This is also the will of GPC England, who in April 2023 voted to prepare to ballot GPs on taking collective action if the Government does not “drastically improve the contract” in 2024/25 negotiations.
At the recent England Conference of LMCs, Conference voted to ballot the profession on the outcome of future negotiations. Tell your colleagues and partners to join the BMA today.
If you are a member, make sure the details we hold for you are up to date to ensure your vote counts. Update your member details on www.bma.org.uk/my-bma or join us as a member today.
Wellbeing resources
We continue to encourage practices to focus on their own team’s wellbeing and take time to reflect on what can be done to protect it (this will also meet the requirements of QOF quality improvement project on staff wellbeing). We have produced a document which includes some tools for improving workload and safe working. A range of wellbeing and support services are also available to doctors, from the BMA’s counselling and peer support services, NHS practitioner health service, Samaritans and Doctors in Distress. See also our poster with 10 tips to help maintain and support wellbeing.
GPC England committee pages and guidance for practices
Read more about the work of GPCE and practical guidance for GP practices. See the latest update on X @BMA_GP and read about BMA in the media. Contact us: info.GPC@bma.org.uk
Read the latest GPC England bulletin
Read the last Sessional GPs newsletter
As the year comes to an end, I wanted to thank you all for your continued work in general practice and for your help and support in the work we do. Please do keep in touch and best wishes for 2024.
Have your say on the future of general practice
Next year marks both the 20th anniversary of the introduction of the 2004 GMS contract, and the end of the current 2019-24 five-year investment framework. A general election is also likely at some point in the year, and potentially, a new government. With change comes opportunity, and a window to influence how we deliver patient care now and for the years ahead.
Manifestos from the main political parties, think tanks, charities, and other health bodies will seek to influence these changes. In advance of these, GPC England will publish its own vision outlining the future direction for general practice by those who know it best: GPs themselves.
This is where you come in. We want to give you a voice.
If you only respond to one survey, make it this one.
We want to hear from all fully qualified GPs in England, whether you’re a BMA member or not.
Share it with all GPs: partners, salaried, retainer and locum GPs; those working in wider primary care roles, in trusts, urgent care, secure or out-of-hours settings, and GP Registrars at ST3 and above. (A separate survey for all GP Trainees ST1+ will be opened by the BMA in the new year – our survey is targeted at ST3+ to ensure that respondents have appropriate experience working within the practice setting to enable them to answer as many questions as possible.)
Participants do not need to be a member of the BMA to participate but we will need a GMC number so we can corroborate responses as coming from qualified GPs based in England.
All responses will be anonymised.
The survey will close on Sunday 21 January 2024. Please: complete the survey as soon as possible, to ensure our negotiating position is as strong as possible.
| Share the Survey with ALL your GP colleagues now: https://tinyurl.com/GPSurveyShare |
Preparation for any future ballot
We need our GP contract to feel safe to sustain services and deliver for our patients. We need our workload to feel safe to retain and recruit GPs and the wider practice workforce. We have been clear with DHSC and NHSE that 2024/25 must bring hope for the future of our profession. This is also the will of your nationally elected body: GPC England, who in April 2023 voted to prepare to ballot GPs on taking collective action if the Government does not “drastically improve the contract” in 2024/25 negotiations.
At the England Conference of LMCs last Friday, Conference voted to ballot the profession on the outcome of future negotiations. Tell your colleagues and partners to join the BMA today.
If you are a member, make sure the details we hold for you are up to date to ensure your vote counts. Update your member details on www.bma.org.uk/my-bma or join us as a member today.
Locum GPs reporting reduced opportunities
In my keynote speech to England LMC Conference last week, I drew attention to where funding is landing, and where investment is being focused. Taking ARRS as an example, the £1.4bn being invested could be spent on 14,000 GPs, increasing GP access to 28 million patients across the country – but it isn’t. The number one aim of PCNs when they were introduced in 2019 was to make the general practice workload more sustainable for PCNs’ constituent practices – but it doesn’t. Our workload has not changed, and in many cases some ARRS roles dilute the capacity of the GPs we have left.
Almost every practice I speak to is experiencing a cashflow crisis. Our concern is that this represents the perfect storm leaving Locum GPs with reduced opportunities for work. Are you a GP Locum who is worried for their future? Tell us in our Survey today, and please share among your Locum networks to provide the BMA with evidence to take forward: https://tinyurl.com/GPSurveyShare
LMC England conference 2023 update and resolutions
Chaired by Avon LMC’s Dr Shaba Nabi, your national representative conference of representatives of England LMCs met last week. The title “Green Lights, Not Red Lines” framed the debates and discussions of the 300+ LMC representatives present, with an additional day’s Special Conference which went into greater detail around continuity of care, funding formulas, and the merits of ‘dissecting’ unplanned from planned care. Read the resolutions and election results here.
eDec Submission deadline – Friday 1st December
The BMA (and many LMCs) have provided advice to practices in relation to completing both questions within the eDec that relate to the Pay Transparency Regulations, that is, Questions 2N and 2O. We do not believe completing question 2O should pose a significant difficulty for practices.
The BMA is reluctant to advise answering ‘no’ if a responder is unable to confirm compliance, as this appears to inappropriately combine two separate and distinct scenarios: one being a definite knowledge (that no self-declaration has been made) and the other being uncertainty about this information. The BMA might suggest that a commissioner should not ask a contractor whether they have complied with the self-declaration requirement on the grounds that someone else does not know whether they have or not.
We note NHSE advice, that if the eDEC response is ‘no’, a commissioner may wish to ask a contractor this question, but simply responding to say that partners have not self-declared cannot of itself be taken as an indication that they should have done so. We believe it is reasonable to suppose that more information would be needed for the commissioner to justify such an enquiry.
The eDec should be completed accurately to the best of the responder’s belief. If, however they do not know because the information is unavailable to them, then question 2N cannot be answered accurately. In these circumstances the GPC recommends this question is N/A, and the practice is recommended to send the following email to ssd.nationalservicedesk@nhs.net
Dear Colleague
I am unable to complete Question 2N because I do not have the information available to be assured of the accuracy of my response.
[Practice Responder Name]
With best wishes
Oliver McGowan Mandatory Training on Learning Disability and Autism
The DHSC consultation into the implementation of the ‘Oliver McGowan Mandatory Training’ has now closed and we are awaiting the recommendations. GPC England has responded, expressing a number of concerns regarding the impact this programme may have on General Practice.
In the interim you should note that there is a legal requirement within the Health and Social Care Act 2022 for GP practice staff to receive training in Autism and Learning Disability. However, whilst the title of the programme includes the word mandatory, this does not mean that any single particular training programme is required. It is for the time being, the DHSC and NHS England recommended programme, so should practices undertake this programme, CQC and ICB teams will accept this.
It is unlikely, at least in the short term, that practices will find it easy to identify alternatives, especially for Tier 2 training, which needs to be delivered by specified trainers including one person with Learning Disability/Autism. If practices do undertake alternative Tier 1 training, it is recommended they ask the training provider for written assurances of the equivalency of their training programme to the Tier 1 Oliver McGowan training (which can be delivered remotely). CQC is waiting to receive clarification in relation to the accreditation of alternative training packages.
Tier 2 training currently involves a full day’s face-to-face training: given the numbers of eligible participants, undertaking such training will cause a significant interruption in service capacity. Ideally Tier 2 training should be delivered over one day only, within six months of receiving Tier 1 training. This creates a difficulty for practices as at present it is unlikely local dates have been set for Tier 2 training and this may not be realistic to do until the outcome of the Consultation is known.
GPC England recommends that the training should be coordinated by local ICB teams working with Training Hubs, once the outcome of the Consultation have been published. CQC’s advice to practices about this type of training is available here.
GP pressures and workforce data
Our BMA teams collate monthly appointment and the latest workforce data onto our website, this has been refreshed and republished today, and is a great resource for signposting PPGs, local press and MPs. October 2023’s data shows that the NHS in England has 2,062 fewer fully qualified FTE GPs than we did in September 2015. The number of GP practices in England has also decreased by 119 over the past year – reflecting a continued trend of closures as well as mergers primarily due to a lack of workforce that coincides with a rise in patients.
As of October 2023, there was another record-high of almost 63 million patients registered with practices in England, with an average of 9,954 patients registered per practice. A single full-time GP is now responsible for an average of 2,300 patients – an increase of 362 more than September 2015.
Click here for more infographics and data on showing the pressures in General Practice.
We urge practices to continue to use our safe working guidance to limit contacts to 25 per day in order to prioritise safe patient care, within the present bounds of the GMS contract.
Shingles technical guidance
NHS England has published updated technical guidance of the shingles vaccination programme. The guidance sets out information on eligible cohorts, clinical codes required to record shingles vaccination events and how payments will be supported via GPES, following the changes to the programme that came into effect from September this year.
MMR Catch-up campaign
NHSE has now confirmed the vaccination ‘catch-up campaign’ for 2023/24. As with last year this will focus on MMR vaccinations and NHSE have set out a number of actions for practices to support the campaign. As per the SFE, practices will receive an item of service fee for every vaccination.
What can we learn from innovation in general practice
Despite current contractual, financial, and capacity constraints, GPs are innovating in different ways to deliver high-quality care and attract and retain staff. In a collection of case-studies, we explore how eight GP providers in England are implementing innovative models, from improving access to a wider range of services for patients to effective chronic disease management. There is no one-size-fits-all solution, but we hope these examples will start a conversation about what is possible and begin to shape a vision for how to solve some of the barriers facing general practice. These models demonstrate that some solutions to the current crisis in general practice already exist but realising them on a larger scale will require far greater investment, contractual flexibility and political will.
GPs have told us that they want to see a model for general practice that allows for autonomy, prioritises continuity of care, encourages and supports innovation, provides variety in their work, retains close ties to the communities they serve, and is cost-effective. England needs a model for general practice that is inclusive and that reflects and supports the different ways modern GPs work as partners in practices and as salaried employees. Read more here
UHUK Awareness Campaign – Winter 2023-24
UHUK is a partnership of urgent and integrated healthcare social enterprise providers who cover 64% of the UK population. UHUK members provide a wide range of NHS services including but not limited to NHS 111, local clinical assessment hubs (CAS), virtual wards, palliative care, Primary Care In and Out of Hours (OOH), Urgent Treatment Centres (UTCs) and A&E triage and treatment.
All UHUK member organisations follow social enterprise principles, meaning any surpluses are reinvested into local services or communities. Starting this month, UHUK is launching an awareness raising campaign to highlight how vital urgent and integrated care providers are to the NHS and the wider health and care system.
The campaign webpage, video and fact sheet can be found at: www.uhuk.co.uk/campaign and UHUK followed on LinkedIn or X.
Wellbeing resources
We continue to encourage practices to focus on their own team’s wellbeing and take time to reflect on what can be done to protect it (this will also meet the requirements of QOF quality improvement project on staff wellbeing). We have produced a document which includes some tools for improving workload and safe working. A range of wellbeing and support services are also available to doctors, from the BMA’s counselling and peer support services, NHS practitioner health service, Samaritans and Doctors in Distress. See also our poster with 10 tips to help maintain and support wellbeing.
Survey on how to prevent and reduce violence towards NHS staff
The Social Partnership Forum and NHS Employers are conducting a survey to inform recommendations on how to prevent and reduce violence towards NHS staff. They are mapping existing work, assessing its impact and identifying measures to reduce violence and aggression towards NHS staff. Take the survey (it takes ten minutes to complete and closes on 22 December).
Undergraduate GP Placement Survey
Medical Schools are currently struggling to identify adequate placement providers in general practice. University of Liverpool is running a survey which aims to identify the factors which affect a practice’s decision to host undergraduate medical students. The data will be used by medical schools to identify drivers and barriers to medical student placements in general practice to tailor placement requirements appropriately and identify strategies to help practices overcome potential barriers.
If you are interested in participating, please read the Participant Information sheet and complete the online survey here (it is fully anonymous and should take no longer than 5 minutes to complete). Please contact Dr Kathryn J Harrison (docthark@liverpool.ac.uk) for any queries.
GPC England committee pages and guidance for practices
Read more about the work of the Committee and practical guidance for GP practices
See the latest update on X (formerly Twitter) @BMA_GP and read about BMA in the media
Contact us: info.GPC@bma.org.uk
Read the latest GPCE newsletter: Complete our new survey | reduced opportunities for locum GPs | LMC conference and resolutions
GPC England meeting update
At last week’s GPC England meeting, we set out a vision for general practice which will further be refined and influenced by the upcoming England Conference of LMCs, and the national survey of the profession – being announced the same day. This survey is to be of all GPs, not just BMA members. Our aspiration is that we survey annually each summer, in time for feedback to be ready ahead of the annual contract negotiation round.
Our vision needs to be rooted in common ground with our patients, and common sense with our commissioners. It will be framed ‘before’ and ‘after’ the 2024 general election. NHS England and the Department of Health and Social Care have already committed to very little change for the 2024/25 contract, but the financial envelope to fund practices has not expanded for 5 years despite population, demand and inflationary rises. We need to push for greatest flexibility, lowest bureaucracy and highest trust to best guarantee practice sustainability.
Once we have fed in your opinion as GPs on the ground across the country, we will be sharing our thoughts with stakeholders of influence, e.g. colleagues at the RCGP and RCN; think tanks; and most importantly of all, patient groups before publishing next Spring in time to influence party manifestos and make protecting general practice a key ’doorstep conversation’ on the election campaign trails.
We need to better the figures released last week by the Institute for Government which demonstrated how “GP numbers have flatlined, while the hospital doctor workforce has burgeoned”; The Economist data which demonstrated the 4% productivity rise in general practice post-pandemic compared with circa 10% drop in the acute sector; the NHS waiting list across England and its driving factors when Trusts were put on captivated budgets and how GPs can likewise reflect on how Trusts chose the speed of their own hamster wheels - this is the foundation of the BMA’s safe working guidance. But we know you would like more evidence, and more examples of how to embed this in your practices. We shall be working on these together with resources for you to share with your PPGs in due course.
Look out for the survey towards the end of the month - this is your opportunity to place your voice at the heart of your future.
General Practice pressures and data
The latest GP workforce data showed that, the net outcome of those newly-qualified GPs joining the workforce in England this August, and those retiring, resulted in a net gain of a mere 56 more full-time equivalent (FTE) GPs by September. Noting the longer-term trend, compared with September 2015, there are still over 2,000 fewer FTE fully qualified GPs. The NHS Long Term Workforce Plan projects a shortfall of 15,000 qualified full-time equivalent GPs by 2036/37 without further policy action. That action cannot come soon enough.
Being a GP can be the best job in the world, but we need the Government to recognise the value and importance of investment and support for our profession, so that we can safely look after our patients, and effectively meet growing demand.
A single full-time GP is now responsible for an average of 2,300 patients. If we are 6000 GPs short as the Government have accepted, this is the equivalent of millions of patients without access to their GP. No wonder services feel so stretched, and no wonder patients perceive the keen loss of “their” family doctor. Click here for more infographics and data on General Practice
Accelerated Access to Records Programme update
GPC England has a new webpage with guidance for practices on how they can provide prospective access to their patients’ GP-held medical records safely, where all our resources are available.
Legally, GPs must act in the interests of their patients. As data controllers, they must see to mitigate data protection risks. Practices are required to carry out a Data Protection Impact Assessment (DPIA) exploring the risks and any possible mitigations as part of the implementation of this programme.
GPC England is supportive of patients having access to their records so long as this is safe for patients and safe for GPs. We continue to put forward the case for making access to records on an opt-in basis.
If you have any examples of where your practice or patients are being put at risk as a result of the programme, please email us on info.gpc@bma.org.uk
Access our template DPIA and other resources on our updated guidance page
Read also: GPs urged to adopt opt-in approach to online patient record access (bma.org.uk)
Physician Associates
At the GPC England meeting we also passed an emergency motion tabled, expressing concern over the increasing trend of Physician Associates (PAs) where erroneously used to replace GPs, and to protect patients by ensuring appropriate processes and regulations are in place. This follows a statement by UEMO (European Union of GPs/Family Doctors) supporting GPs in the UK over our concerns.
The BMA recognises the vital role that multidisciplinary teams play in General Practice, but patients need to know and understand what each healthcare professional can and cannot do, and where their expertise is relevant. There have been some recent examples suggesting a potential blurring of lines between doctors and non-medically qualified professionals, leading patients to think they’ve seen a GP - when they haven’t.
PAs are not doctors, they are not regulated, and they cannot prescribe. The distinction between GPs as expert medical generalists, and PAs, must be protected. PAs cannot be used as a substitute for GPs, or in place of a GP when supervising GPs in training.
The GP workforce crisis is a result of the failure of Government to plan for the recruitment and retention of GPs. Only by valuing and investing in the recruitment and retention of GPs will the experience and care of patients improve. While PAs may help reduce general practice workload in some well-defined cases and pathways, it should not come at the expense of patient safety.
Read my full statement here
Seasonal Vaccination Update
The Co-administration template is now available as of 23 October, and this should be now available to all sites who are using the system. NHSE have advised that the delays to the co-administration template came about due to the accelerated timelines of the programme. “Pinnacle had to prioritise their workload to ensure that rapid development of POC systems could be achieved. Our digital colleagues worked with Pinnacle to introduce it as soon as possible, recognising that it is a very important functionality for sites.”
The additional financial support, which came to an end on 31 October, was put in place to support programme acceleration (i.e. to administer as many Covid-19 vaccinations before the end of October) and to recognise the additional administrative, organisation and delivery costs associated with that ask. The UKHSA and DHSC are responsible for monitoring the epidemiology and advising NHS England where further steps need to be taken in response to emerging Covid-19 variants. They have been monitoring the situation, and do not regard additional measures as necessary at this stage. Therefore, at this point in time, there are no plans to extend the additional financial support. However, it appears that patients are coming forward less quickly this Autumn compared with last. The UKHSA’s uptake reports are available here.
Regarding staff vaccination for flu, provision is an employer responsibility and not provided under the NHS flu programme. Frontline primary care staff are not eligible for a free NHS flu vaccination and therefore are not included in the Annual Flu Letter cohorts, but they do appear in the enhanced service spec because the decision was taken last year to include frontline primary care staff in the spec to allow for cover under the Clinical Negligence Scheme for General Practice, as provision of flu vaccinations to these staff is an employer responsibility.
Navigating GP Premises Service Charges
In 2022, the cases of Valley View & Others v NHS Property Services (which were supported by the BMA) considered five different scenarios where service charges (charged by landlord NHS Property Services) were disputed.
Service charges usually arise where the GP practice doesn’t own the premises and the landlord provides repair and maintenance. Here, NHS Property Service’s default position was to charge pursuant to its Charging Policy.
However, the Court concluded that the Charging Policy doesn’t override the terms of the tenancy agreement. While these cases don’t set a universal precedent, there are useful points that may assist GP practices in resolving disputes or pushing back on service charges raised.
The sums initially demanded by NHSPS in the cases of Valley View & Others were significantly higher than what was ultimately paid by the practices. The BMA successfully assisted the five practices in the cases to significantly reduce service charge claims, with one practice agreeing to a reduction of more than 80%.
BMA Law has ateam of legal professionals specialising in healthcare related law and can advise GP practices in respect of service charge issues. To discuss NHSPS service charges and other related matters please BMA Law on 0300 123 2014 or email info@bmalaw.co.uk
LMC England conference 2023
The Agenda for the 2023 LMC England Conference in London which takes place on 23 -24 November, has now been published. For more information see here
Please send any queries to info.lmcconference@bma.org.uk
GP trainees committee renames itself the GP registrars committee
The BMA’s GP trainees committee has now officially changed its name to the GP registrars committee.
The decision to change the committee name was made to reduce confusion for patients as it better reflects their roles as fully qualified doctors, and it is a step to regaining the professional respect that all GP registrars deserve.
You can read more about how the GP registrars committee is working toward regaining their professional identity in this blog by the GP registrars committee chair, Dr Malinga Ratwatte.
NHS Suicide Postvention Guidance for staff
The University of Surrey, Keele University, and the University of Birmingham have developed postvention guidance for NHS services on how to support staff after the death by suicide of a colleague. The Social Partnership Forum Workforce Interest Group, of which the BMA is a member, have been asked to circulate the executive summary and full report for your information.
Wellbeing resources
We continue to encourage practices to focus on their own team’s wellbeing and take time to reflect on what can be done to protect it (this will also meet the requirements of QOF quality improvement project on staff wellbeing). We have produced a document which includes some tools for improving workload and safe working. A range of wellbeing and support services are also available to doctors, from the BMA’s counselling and peer support services, NHS practitioner health service, Samaritans and Doctors in Distress. See also our poster with 10 tips to help maintain and support wellbeing.
GPC England committee pages and guidance for practices
Read more about the work of the Committee and practical guidance for GP practices
See the latest update on X (formerly Twitter) @BMA_GP and read about BMA in the media
Contact us: info.GPC@bma.org.uk
Read the latest GPCE newsletter: GPC England meeting update | new GP workforce data | accelerated access to records programme guidance
Read the latest Sessional GPs newsletter
Accelerated Access to Records Programme update
Following on from the additional guidance that we shared with practices last Friday about the imminent contractual requirement to give all patients online access to their prospective records from 31 October 2023, we have updated and published some further resources.
Practices are strongly advised to carry out a Data Protection Impact Assessment (DPIA) if they have not already done so, and may wish to use the BMA’s DPIA as a template. If your DPIA suggests there may be a high risk to patients, then we advise you to separately inform the Information Commissioner’s Office (ICO) and your ICB commissioner.
We have provided a template letter for the ICO which you can use to flag high risks associated with providing prospective online access and therefore stating that the GP, as data controller, is unable to go ahead with processing.
We have also provided a template letter for your ICB team which includes questions that you may wish to ask your commissioner based around your potential concerns.
If you have not ‘gone live’ and wish to make use of EMIS’ offer to bulk provision access at a later date, we recommend you contact your ICB primary care IT team ahead of 31 October 2023.
We strongly recommend that you inform your patients regarding the provision of access to let them know it is happening (guidelines on how to do this in ‘Reference A’ within the FAQs)
We would encourage practices to engage with and agree a way forward with your local commissioning team to ensure they are fully informed and updated of the practice plan, including any bulk communications you may plan to send to patients.
We have also issued a joint statement with Violence Against Women and Girls organisations, including Refuge, Women’s Aid, and EVAW (End Violence Against Women Coalition), highlighting outstanding concerns we have around the implications of automatic prospective online access for domestic abuse survivors. Read more here
Read our full guidance here
PCSE Seniority Payments Reconciliation Exercise 2023
Some practices may recently have received letters from PCSE regarding the Seniority Payments Reconciliation Exercise 2023.
Seniority Payments used to be made to GP partners and were based on length of NHS service and received profit. The seniority scheme closed to new members on 1 April 2014, and was then phased out, with the last payments made by 31 March 2020. Seniority funding was then diverted to Global Sum, as part of the 2013/14 Contract Agreement.
The actual entitlement to seniority pay depended on the Final Seniority Factor [FSF] and as there was a time-lag in calculating this, the FSF for financial years 2017/18, 2018/19, and 2019/20 have only just been published. NHS England and PCSE are now reviewing the adjustments made for those years and will be contacting practices once this has occurred.
Current partners should advise their accountants of the information that has been received from PCSE, as the amounts can be challenged via the on-line form link within the letter received from PCSE. In a limited number of cases, there will be a need to liaise with retired colleagues, and the matter may not always be covered by written arrangements.
GPCE recommends that practices first ask their accountants for advice in terms of PCSE figures, raising a query if appropriate, which may not be a value-for-money exercise if the variance is small.
If you have any queries regarding this process, please contact us on info.lmcqueries@bma.org.uk
Here is our letter to practices which we would encourage you to share.
GPCE and RCN joint Statement on GP practice staff pay uplift 2023/24
GPC England (GPCE) and the Royal College of Nursing (RCN) and have issued a joint statement to alert their respective members to the details of the recently announced 6% pay increase for salaried general practice staff. The way the expenses uplift is applied leads to some inequity amongst GP practices. This means some practices will not receive enough additional funding to cover an entire 6% uplift for all salaried staff members.
Securing recurrent pay uplifts for all practice staff is vital for the future success of General Practice. Key to successfully negotiating with the Government in forthcoming contract negotiations 2024/25 and 2025/2026 is making the case that staff should be fairly paid and benefit from rewarding working conditions. The GPCE and RCN are committed to working closely together to ensure appropriate and fair funding for Nurses in General Practice as an integral part of the General Practice Team. Read the statement here
Wellbeing resources
We continue to encourage practices to focus on their own team’s wellbeing and take time to reflect on what can be done to protect it (this will also meet the requirements of QOF quality improvement project on staff wellbeing). We have produced a document which includes some tools for improving workload and safe working. A range of wellbeing and support services are also available to doctors, from the BMA’s counselling and peer support services, NHS practitioner health service, Samaritans and Doctors in Distress. See also our poster with 10 tips to help maintain and support wellbeing.
GPC England committee pages and guidance for practices
Read more about the work of the Committee and practical guidance for GP practices
See the latest update on X (formerly Twitter) @BMA_GP and read about BMA in the media
Contact us: info.GPC@bma.org.uk
Read the latest GPCE newsletter: Accelerated access to records programme | seniority payments reconciliation exercise | pay uplift joint statement
