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New GP contract will result in practice closures, says BMA

NHS England has announced a new GP contract for 2024/25, which aims to cut bureaucracy, provide more staffing flexibility and improve patient outcomes.

NHS England has announced a new GP contract for 2024/25, which aims to cut bureaucracy, provide more staffing flexibility and improve patient outcomes.

However, the BMA says the contract amounts to more cuts for services, which will likely result in practice closures and reduced patient access.

Dr Katie Bramall-Stainer, chair of GPC England at BMA, said: “GPs will see another year of cuts to their total practice income per patient which itself has only risen by £15 in over a decade, despite 1,000 practices being lost, 2,000 fewer GPs and over 6,000,000 more patients registered with practices across England.

“For this contract to match 2019/20 funding, it would need an 8.7% uplift. Instead, it’s another effective cut of 1.9% and a third consecutive imposition.”

Dr Bramall-Stainer says the lack of funding will result in “staff redundancies, loss of the GP workforce, fewer GP Nurses, reduced activity, reduced access and an unacceptable experience for our patients.”

GP contract aims to ‘improve patient access’

The letter, which is addressed to all GP practices in England as well as primary care networks and their clinical directors, says the new contract aims to make ‘simpler and more flexible arrangements’, which will help to free up GP time and improve patient access and experience.

From April, NHS England says it will:

  • Increase pay for GPs and staff by 2%, with a possible uplift following the Government’s response to the pay review body process.
  • Protect 32 out of the 76 Quality and Outcomes Framework (QOF) indicators, meaning payments will be made irrespective of activity recorded for these 32 indicators.
  • Reduce the number of Investment and Impact Fund (IIF) indicators from five to two. The remaining three indicators will be incorporated into the Capacity and Access Payment (CAP), which will increase by £46m.
  • Increase the QOF aspiration payment from 70% to 80% of the contractor’s previous year’s Unadjusted Achievement Payment.
  • Start paying the Capacity and Access Improvement Payment (CAIP) at any point in the year, once the primary care network has confirmed they meet the criteria for payment.
  • Include enhanced nurses in the Additional Roles Reimbursement Scheme (ARRS) to give PCNs more staffing flexibility. NHS England will also give PCNs and GPs more flexibility by removing all caps on all other direct patient care roles.
  • Simplify the Directed Enhanced Service (DES) requirements to improve outcomes.
  • Review the data digital telephony systems generate to better understand overall demand on general practice in advance of winter. PCNs and practices are asked to review the data that digital telephony systems generate ahead of its extraction in October.

NHS England says it will now begin the process of implementing the 2024/25 contract changes with detailed guidance and further information to be published in the coming weeks.

Dr Amanda Doyle OBE, National Director for Primary Care and Community Services, said: “We hope that the arrangements we are putting in place will further support you in delivering high quality healthcare to our patients.

“The pace, determination and dedication of general practice is inspiring and on behalf of patients, we are grateful for your continued hard work.”

Members will be ‘dismayed’ at lack of additional investment

Ruth Rankine, director of primary care at the NHS Confederation, has welcomed the “increased freedoms and flexibilities” the contract offers, but warns that additional investment is required.

“The inclusion of additional nurses to the ARRS scheme and removal of caps to recruiting to patient care roles will help bring additional staff into primary care. Primary care leaders will also welcome streamlining the Quality frameworks to reduce the bureaucracy and focus on those that have greatest impact on health outcomes.

“However, our members will be dismayed at the level of additional investment given how much they have achieved during and since the pandemic. There is a risk that we compromise the sustainability of general practice and the significant progress that has been achieved through PCNs,” she said.

The BMA says it now fears the government has lost its “final opportunity to avoid a preventable chain of events which will be viewed with anxiety and concern by the 1.39 million patients who consult their GP surgery each and every day.”

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