GP contract negotiations and future of general practice
As you will probably be aware, despite negotiations between GPC England and NHS England about amendments to the five year contract deal agreed in 2019, NHS England announced last week that the contract amendments will come into effect from 1 April, without an agreement or endorsement by the BMA.
We are bitterly disappointed with these changes to the GP contract, which fail to help patients and support practices at this critical time.
The negotiations reached a stalemate in mid-February when it became clear that NHS England would not be offering an update that would impact meaningfully on patient care, nor provide the support desperately required for general practice as it faces unprecedented pressures and pandemic recovery, despite GPC England suggesting a number of solutions to address some of these pressures, enabling practices to support patients.
Read the full BMA statement here and our response to misleading comments about our involvement in the contract changes.
GP contract 22/23 – guidance for practices
Read our guidance about the contract changes to support practices in their decision making and next steps.
Safe working in general practice
General practice is in crisis, with increasing patient need and demand, coupled with a shrinking and exhausted workforce, as well as a vast backlog of care following from the COVID-19 pandemic, exerting greater pressure on a system already at breaking point.
As a result of these challenges, GPCE has published a safe working guide to enable practices to prioritise safe patient care, within the present bounds of the GMS contract. Present resource in general practice is finite, though we must continue to deliver high quality, safe care to our patients. As a result of resource decisions by practices, it may be the case that some patients will regrettably wait longer to access GP care for their non-urgent problems, or are directed to another more appropriate provider.
Meeting with Secretary of State and NHS health care reforms
This week Dr Farah Jameel, GPC England Chair, attended a meeting with Sajid Javid MP, Secretary of State for Health and Social Care, alongside BMA Chair of Council, Dr Chaand Nagpaul. The meeting was an opportunity for the Secretary of State to outline the key themes from his ‘Road to Recovery Speech’, which he delivered the following day. The BMA response to that speech can be viewed here.
The meeting was also an opportunity for us to raise the case for general practice. In particular we outlined the continued and growing pressures facing the general practice workforce, and also reflected on the mood of the profession in response to the contract announcement from NHSE/I – outlining what further measures we have been calling for.
Policy Exchange report on the future of general practice
We were pleased to see that the recent Policy Exchange report of future of general practice, supported by the Secretary of State, recognises the importance of what GPs and their teams do for their communities, and understands that there are some deep-seated problems that need to be urgently addressed, and begins to articulate some ways to make general practice services sustainable for the future. The BMA will be providing a more detailed critique of this report in the coming weeks. Read the BMA statement in response.
GPCE executive team changes
On the 28th February, I (Dr Dean Eggitt) announced my resignation from the GPC England executive team and I expect to leave the role on 12 April. The following is an extract of my resignation letter, that I wanted to share with the profession.
“It is with great regret that I submit my resignation as a GPC England executive officer.
I applied for this post with the aim of working on the refresh and reset that Dr Farah Jameel set out on her appointment as Chair, and I was excited to witness the historic democratic election of the first female Chair of GPCE.
I was honoured to have been given the once-in-a-lifetime opportunity to represent our nation as a part of her team.
Sadly, the role is not compatible with my desire to have a normal family life. So, I must resign.
I thank you all for your support. I wish you all good health and happiness.”
In response to the announcement, Dr Farah Jameel, Chair of GPC England, said:
“Dr Eggitt has been a dedicated and enthusiastic member of the Executive and I thank him for his commitment and the ideas he has brought during his tenure. I am sorry to see him go and wish him well for the future. We will, in due course, be setting out the process the BMA will follow to appoint his successor.”
Data on the pressures facing general practice
Pressures on general practice such as workforce shortages are still as severe as ever, and is evident in the latest data from NHS Digital for the GP workforce in January which shows that there is now the equivalent of 1,608 fewer fully qualified full time GPs than in 2015. This is in addition to the average number of patients each GP is responsible for having increased by around 300 since 2015.
The Institute for Government has produced a performance tracker for general practice for 2021, which draws together data from various sources on the state of general practice and the challenges facing it in the context of the pandemic. It also addresses some of the challenges to recovery and provides estimates for projected demand, concluding that the largest concern for general practice is the need to increase staff numbers.
The Health Foundation’s webpage on understanding activity in general practice has more up to date figures and in particular provides detailed explanations of the scope, quality and detail of GP appointments data, to show what appointment data can or can’t tell us.
The BMA’s own webpage on pressures in general practice data analysis includes key figures on workforce and appointments that are updated each month, alongside what the BMA has been calling for, for general practice.
BMA successfully challenges threatening letters from solicitors
A number of solicitors have been threatening doctors with legal action if the doctor does not provide COVID-19 exemption for the solicitor’s clients. The BMA’s Medico Legal Committee (MLC) has written to the Solicitor’s Regulation Authority (SRA), and has been assured that solicitors should not be “writing in offensive, threatening or intimidatory ways. And we also do not expect solicitors to pursue matters which they know have no legal merit.”
If doctors receive intimidating letters, please advise your Medical Defence Organisation (MDO) and share a copy with us at info.gpc@bma.org.uk so that the MLC may pursue further via the SRA.
Furthermore the GPC and the MLC have met with the COVID-19 Exemptions Team at the Department of Health and Social Care (DHSC). We understand that further guidance on COVID-19 exemptions will be published and this will clarify the role of doctors in providing exemption certificates, make it clear what conditions do and do not warrant an exemption, and reiterate that there is no appeal. We have asked for departmental support that any legal action is against the policy, and thus the DHSC, and not the GP/surgery. Both committees hope to see a swift and satisfactory conclusion to this matter.
NHSPS service charges dispute update - trial dates
The BMA is supporting five test claimant GP practices who have received demands from NHS Property Services (NHSPS) to pay inflated service charges based on its “full cost recovery” approach, outlined in NHSPS’ Consolidated Charging Policy (‘the Policy’). These court proceedings were brought against NHSPS for a declaration that the Policy does not form part of their tenancy and therefore NHSPS cannot base their charges on it.
The trial will begin on 17 March 2022 and will be concluded no later than 5 April 2022.
The Lawyer magazine has selected the caseasone of the top 20 cases to watch in 2022.The case was pursued because of its national significance and has required a huge amount of time and effort from everyone involved, and it is good to see this being recognised. This is a good example of a grassroots issue that is being supported by the BMA at considerable risk and costs. Irrespective of the final outcome this case shows that the BMA is prepared to support doctors in difficult circumstances. Read the statement from our legal team at Capital Law.
Kings Fund report on Additional Roles Reimbursement Scheme (ARRS)
The King’s Fund has published a major report on the ARRS, which focuses on four roles — social prescribing link workers; first contact physiotherapists; paramedics and pharmacists — to examine the issues related to the implementation of these roles, looking at the experiences of working in these roles and of the people managing them.
The report found a lack of shared understanding about the purpose or potential contribution of the roles, combined with an overall ambiguity about what multidisciplinary working would mean for GPs. It also found that successful implementation of the scheme requires extensive cultural, organisational and leadership development skills that are not easily accessible to PCNs.
Guidance for 2022/23 seasonal flu vaccination programme
NHS England has published guidance on the recommended vaccines and eligible cohorts for the 2022/23 seasonal flu vaccination programme.
The guidance highlights that in 2022/23, the NHS flu vaccination programme will only be offered to patient groups eligible in line with pre-pandemic recommendations. This means that 50-64 year olds, and frontline health and social care workers will not be included in the national programme for the coming year. Practices will therefore need to revert to their previous occupational health arrangements for the vaccination of practice staff.
Mandatory vaccinations for healthcare staff to be revoked
The proposed requirement of mandatory vaccinations for health and social care staff, which was supposed to come into force in England on 1 April, will be revoked on 15 March 2022.
If you have been affected by this issue, please contact the BMA’s employment advisers.
LMC UK Conference 2022
The 2022 UK LMC Conference will take place 10 and 11 May and will be held face to face in York at the Barbican Centre. LMCs are reminded to complete the registration form by no later than Friday 8 April 2022. Please note that we would be unable to fulfil registration requests beyond that date.
We aim to publish the final Agenda on the BMA website on 22 April 2022, and it will also be emailed directly to those who have registered and LMCs as soon as it is available.
Read more about the conference, how to register and to submit motions on the BMA websiteIf you have any queries, please contact us at: info.lmcconference@bma.org.uk
Read the latest GP bulletin (England) here
GPC England – information and guidance
Read more about the work of the GPC England
Read practical guidance for GP practices
See the latest update on Twitter: @BMA_GP / Twitter @DrFJameel / Twitter
Read about BMA in the media: BMA media centre | British Medical Association
From now on our updates will be published fortnightly.
