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The waiting game

Reaction to the new GP contract for 2020/21

This year's new GP contract has been released, including a 4% increase to the global sum, £20,000 golden handshakes to attract GPs into partnership, additional funding for primary care networks to hire extra clinical roles and pared back network service specifications.

GPs, health officials and contract negotiatiors have their say on the changes:

RCGP chair Professor Martin Marshall: 'This is an encouraging contract and we thank our colleagues at the GP Committee of the BMA for their negotiations on our behalf.

'We hope it will serve as a catalyst to deliver the funding and workforce pledges that have been made and are so desperately needed to ensure general practice is sustainable in the future.

'This contract should help us to deliver services that will be beneficial for patients whilst relieving workload and providing much-needed support for hard pressed GPs.

'We are pleased that NHS England has responded to many of the recommendations made by the college in our recent workforce roadmap and has listened to the profession by making their proposed specifications for primary care networks, which caused great consternation within the profession, less onerous. This should help to ensure that PCNs have the time and space to succeed.'

Health Secretary Matt Hancock: 'I want the NHS to be there for everyone when they need it, and to take pressure off hospitals by expanding primary care.

'This new contract is the first step to delivering our manifesto commitment to make it easier to get a GP appointment when you need it by delivering 50 million more appointments a year in general practice.

'The significant additional investment means GP surgeries can recruit more pharmacists, physiotherapists and other health professionals so patients get the right care for them when they need it. It’s all part of our commitment to ensure the NHS is always there for everyone.'

NHS England chief executive Sir Simon Stevens: 'This agreement funds a major increase in general practice staff - including GPs, therapists and pharmacists - so that patients can get quicker appointments with a wide range of skilled health professionals at their local doctors’ surgery.

'These extra staff will in turn be offering expanded services, including regular health checks for people living in care homes, action to boost vaccination uptake, earlier cancer detection, and better support for people with learning disabilities.

'Coming on the heels of the highest ever number of young doctors now choosing to train as GPs, this is a vote of confidence in general practice that goes with the grain both of what patients need and what GPs themselves want to provide.'

Dr Nikita Kanani, NHS medical director for primary care: 'This agreement means better care for patients, and will help relieve pressure in general practice. This contract is good news for practising GPs, and supports our practices in the new primary care networks to bring in extra skilled staff, and recruit and retain our GPs.

Ian Dodge, NHS national director of strategy: 'Today’s deal is another important moment, when general practice is given the practical support it needs to expand patient care. And with a much bigger team, and more GPs, it becomes possible to provide new services and improve access for patients.'

Lancashire and Cumbria LMCs chief executive Peter Higgins: 'My first feeling is one of relief - relief that we seem to have got it back from the brink and back on track. We need to feel reassured that our leaders within NHS England and within the GP Committee seem to be on the same page, recognise the problem and come up with some real practical solutions.

'The headlines sound good. They do seem to address some of the major concerns that we have and the PCNs have and I do think there are some real initiatives to try to help the workforce crisis even further.

'This contract deal is not going to solve all the problems that we have, but it's a good start.'

Dr Kamal Sidhu, a GP in County Durham: 'PCNs will heave a sigh of relief as the new offer is much better. Full reimbursement for additional roles is very welcome. NHS England has clearly listened to the profession.

'We just hope that the local commissioners now play ball and actually support practices help develop collaboration.

'I would also wish to see more detail around requirements from some of the additional roles as to how many other strings come attached to these roles and how many get added on at the local level. Some of the new roles are relatively untested and we will need to see the real impact on the workload.

'It is good to see some incentive for the incoming partners but it would have been very appropriate to focus on retention across the board ie in form of some reward for experience and for the real hard work happening on the ground.

'There is not much on the pensions issue either other than a relatively vague statement which is a massive concern  for so many of us.

'Despite all these new additional roles, there is a need to fund the contract better to deliver more frontline care in line with the demand.'

Dr Katie Bramall-Stainer, chief executive of Cambridgeshire LMC: 'This contract is generally helpful...Many of our concerns articulated last month to NHS England and NHS Improvement have been addressed.

'The monies being invested in additional roles help quantify just how much disinvestment practices have experienced in the past decade; yet these monies are primarily into primary and community care staff. The system needs to appreciate that this is an investment into the nascent integrated care agenda rather more than an explicit investment into core general practice.

'Individual practices are still fragile, understaffed and overworked. These monies do not represent a quick fix. But they do provide cautious optimism for the longer term.

'We welcome the commitment to the recruitment of our future GP workforce, but the devil will be in the detail of how we can work the practical implications through in terms of the capacity in our surgery buildings, and the senior GP clinicians available, with providing support for the development of these new roles.

'The new partnership loan is another helpful gesture, but needs to be seen in the context of being spread across four years, deducting tax and superannuation, and excluding former partners.

'However it is a positive step, and we are determined to make this work, as trust has been placed in us - not least in the service specifications, reduced to 3.5 from 15 pages and refreshingly light on bureaucratic box-ticking.

Walsall LMC medical secretary Dr Uzma Ahmad said: 'Overall I think it's really good that we've got 100% reimbursement for the additional staff that we're going to get.

'Recruitment varies from region to region, especially if you're talking about more remote areas. There will be variation and that has to be acceptable.

'Although the PCN specifications are much reduced from what was in the original plans I think we still need to make sure that they are achievable. PCNs need to be established first, rather than CCGs trying to micromanage.'

 

Kent LMC medical secretary Dr John Allingham: '100% reimbursement for the additional staff is good, the £20,000 golden hello may suck a few people into partnership - we hope so - and the 4% uplift in the global sum is better than we've had for ages.

'We're always cautiously optimistic because they [NHS England] tend to give with one hand and take with the other and we've all been there before. But on the face of it, it looks good and it does look like they're going to give us the money to do the work, but they're also going to allow us to get the staff to do work.'

 

 

 

 

 

 

Readers' comments (6)

  • Cobblers

    Dr Nikita Kanani, NHS medical director for primary care:

    'This agreement means better care for patients (How?), and will help relieve pressure in general practice (No it won't). This contract is good news for practising GPs (It isn't), and supports our practices in the new primary care networks to bring in extra skilled staff (Nope), and recruit and retain our GPs (Really?).

    Wrong on all counts Dr Kanani.

    Let's hope this one gets through the censor.

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  • 'These extra staff will in turn be offering expanded services, including regular health checks for people living in care homes, action to boost vaccination uptake, earlier cancer detection, and better support for people with learning disabilities.'

    Simon Stevens appears to confirm that the extra staff will be tied up with additional services rather than supporting the practices. At least we will not be subsidising them but it does not suggest that they will do anything to reduce pressures on core GP work

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  • Gobble gobble, I vote for a delayed Christmas.

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  • Look promising. Can comment after using

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  • Bringing back the unnecessary luxury of the 6 week post-natal check takes the GP away from seeing patients who really need their attention.

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  • Bob Hodges

    So the average GP appointment is otherwise invariably taken up by someone that actually needs to see a doctor?

    On which planet is this?

    In planet UK NHS, the average GP appointment is booked by someone who wasn't sure whether or not they needed to see a GP, so they booked a GP appointment to talk about it. The other 10% are booked by people who want to know whne the hospital are going to seend their appointment through.

    Post natal checks are really valuable when used correctly and with a little imagination. A significant number of ladies will book an appointment in the post-natal period for various reasons anyway, those appointments can be preempted.

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