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GPs buried under trusts' workload dump

GPs to call for ‘immediate’ withdrawal of new contract at BMA annual conference

GPs will debate a motion calling for the ‘immediate withdrawal’ of the five-year contract later this month at the BMA annual representative meeting (ARM).

The motion was put forward by the London Regional Council, who are ‘opposed’ to the framework agreement and are insisting for all GPs and trainee GP BMA members to be allowed a vote on it.

The council also suggests the ‘real agenda of GP contract change’ is to make GP practices ‘hastily’ sign primary care network deals and run independent practices into ‘extinction’.

The motion, included in the agenda for the BMA ARM on 23-27 June, says: ‘That this meeting believes this heist of GP registered NHS patients and their capitated budgets through dint of making primary care contract holders hastily sign network contracts and agreements by May 2019, suggests that the real agenda of GP contract change is to ‘evolve’ independent GP practices into extinction over five years and replace them with ICS -run primary care.’

Another motion put forward by London Regional Council states that the contract has been agreed without a ballot from BMA members.

It says: ‘That this meeting is astonished that “Investment and evolution: A five -year framework for contract reform to implement the NHS Long Term Plan” 31 1.19 has been agreed by GPC England without balloting GP BMA members.

The BMA has said it would not comment on any motion ahead of the ARM.

Last month, it was found that the BMA’s legal service was charging members up to £5,000 for networks seeking legal advice. LMC leaders said it was not fair for practices to cough up the funding to join networks, which were negotiated by the BMA. 

Accountants have also previously warned that practices should ‘think twice’ about signing network contracts due to potential issues with VAT and HR.

Readers' comments (18)

  • you are not legally obliged to sign up to it so I would advise don't. The care home aspect is possibly racist against those communities that look after their families at home, as in many asian communities, and don't use care homes or in practices that have no care homes but many housebound patients. There is no funding agreed after 5 years so you employ these people and then you may have to make them redundant. you will pay for this. You also pay 30% of their pay out of your practice profits and you cannot employ them for vacant posts. After next year you pay their 20% employers contributions out of your practice profits as well. lots of the extra costs will come out of your global sum over time reducing your practice profits. its a bad contract. the funding for IT isn't sorted and the system isn't coping with the workload we have as it is, it won't work without more IT in place right now and should have been sorted first.
    90% of councils are dumping public health onto GP practices with no funding and CCGs will have to pay extra to networks by reducing services elsewhere. Current LES and DES arrangements will probably be cut to pay for the CCG component.
    whoever negotiated this needs to resign as they clearly do not understand general practice or even worse don't care.
    I thought i lived in a democracy. I am not in the BMA. I did not vote for this and the BMA does not represent me. Why were we all not asked to vote on it? . this contract will decimate partnerships. shameful.

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  • As a partner in a small 7.5k practice, I personally feel that the introduction of networks will hasten the demise of small practices. Only those practices that constitute a network in their own right will be able to survive.

    The whole premise of a network is so legally and corporately complicated that any benefits will only be seen by super-practices which do not have to legally or corporately interact with another practice. Taking indemnification of risks of practices in a network as an example, the problems and risks are significant.

    We either have to take a broad approach as essentially we are all going into partnership with each other in respect of the network responsibilities. We therefore take it on in a "partnership" approach and become joint and severally liable for the network. That is we are all in it together and share ALL the risk no matter what.

    For example an employing practice discriminates against a network employee, the employee claims against the employing practice and is successful. With a broad approach to indemnifying the risk-holding employing practice, all the other practices would chip in to cover the practice that has been deemed to have been discriminatory.

    However in a more narrow approach, one could say that an employing practice should act legally and in a non-discriminatory manner and hence if the practice acts contrary to this, why should the other indemnifying practices extend the indemnity to illegal or discriminatory actions?

    The situation gets even more complicated and convoluted when network employees will presumably work across different practices. What indemnities are we happy to give or receive as the partnership where a network employee works? Would we expect to be indemnified for any breaches of Health and Safety legislation that befall the network employee whilst on our premises or any claims of discriminatory behaviour? Likewise are we happy to indemnify other non employing practices for potential breaches of Health and Safety law, or any of the other myriad of legislation and guidance that have to be adhered to when the employee is on their premises?

    What indemnities are needed and how far do they go in relation to issues with the network employee working on non-employing practices' premises? What happens if a network employee significantly breaches GDPR? Where does the risk/responsibility lie? When GDPR breaches can result in fines of up to 4% of annual revenues or 20 million Euros, non-compliance with rules can have significant effects on a practice. I would therefor want to know exactly what risks I am running or offering to cover for others.

    Similar complications appear to arise in a "bank" practice. If a "bank" practice fails to make a network payment on time and that practice makes a larger on paper profit for that year, then there is a risk the "bank" practice partners can be personally liable for tax and pension contributions on that network "profit". Would the indemnity for financial matters extend to that practice if there were reasonable explanation, or if it were due to an inaction of a practice employee, or if it were due to a negligent act of that practice? There is a similar risk with falling foul of VAT rules.

    Agreements on interdependent indemnification are not the only complicated facet. In relation to corporate governance, legal agreements similar to articles and memoranda of association for companies will have to be generated and the networks run by them, each defining what powers and responsibilities individuals and organisations have in the network.

    In addition the running of networks will have to be set up so as to minimise the potential impact of VAT on the supply of services.

    There appear to be a myriad of complicating legal tax and accounting pitfalls in all this. I am sure the magic porridge pot £1-50 per head set up funding will cover all this, and all the meetings, and all the 30% funding deficit of network employees. Or possibly not?

    Three cheers to the boffins who thought this was a good idea!

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  • Just Your Average Joe

    PCN forcing GPs to take on extended access and stretching already paper thin staff to work longer hours.

    This is going to turn into an insurance policy for the DOH with PCN eventually having to mop up patients if practices within them close, as a duty of care to the patients within the network. Then the closing and failing practices will become the problem of the remaining practices.

    The PCN is a trojan horse loaded with Sh!t disguised as extra funding to help us swallow it.

    Please turn back this policy of preparing primary care into parcel sized portions ready for privatisation.

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  • https://www.youtube.com/watch?v=l4wQ577Me30

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  • Will not be doing more sessions, so with extended access will be taken from another part of my day.Spread the jam thinner you will not be able to tase it.Well done BMA who ever negotiated this sh** needs to resign a real pi** poor effort on your part.

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  • Concerned grassroot member - great video! Can we put these two up against Nikita and Co in a live debate?

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  • This Contract highlights just how far removed the agenda of the BMA has become from the interests of GPs.

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  • What is the point of this?

    The contract is terrible, most of us should know that. But everyone still signed. Ours was the ONLY practice in our locality that didn't.

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  • Oh please do (vote to withdraw it). We should have some say in our terms of employment other than sign it or close and there is so much in this latest rehash causing concern.

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  • Concerned grassroot member - I think some of that video drifts well into the tinfoil hat conspiracy theory territory. The new contract has downsides and the timescale is tricky but some of the "consequences" of the contract mentioned are highly speculative or just lacking evidence base. Great to see such enthusiasm and passion and willingness to speak out but scare-mongering isn't the same as informing people.

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