We are confident that these widespread changes – the most significant in 15 years – will deliver the best not just for GPs across England, but also for the patients they treat on a daily basis. Last month, the Government announced its Long-Term Plan for the health service, and our negotiations with NHS England were key to shaping this vision for general practice, as is evident in many of the details revealed today.
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Recent years have seen hard-working family doctors deal with an overstretched workforce doing their best to meet rising demand from patients suffering more and more complex conditions, all on the back of a decade of underinvestment in general practice.
Therefore, we are pleased after months of discussions with NHS England, to have negotiated a package of reforms to the GP contract and beyond, that will begin addressing the unsustainable situation – whereby doctors are choosing to leave the profession while patients wait longer and longer for appointments – and laying the foundations for a general practice fit for the future.
Support and funding for Primary Care Networks mean practices can work together, led by a single GP, and employ additional staff to provide a range of services in the local area, ensuring patients have ready access to the right healthcare professional, and helping reduce workload pressures on GPs. This significant expansion in the workforce, which will eventually see over 20,000 healthcare staff based in networks across England, will also be expected to focus on some of the Long-Term Plan’s commitments, such as support for care home residents and the earlier identification of people with cancer or cardio-vascular disease.
While the way it is funded will change, networks will continue to offer evening and weekend appointments to all patients, and as part of this effort to improve access, practices will have to make one appointment available a day available for every 3,000 patients on their list to be directly booked through NHS 111.
The Secretary of State for Health and Social Care has made his ambitions around technology in general practice clear, and GPs recognise the potential convenience that new systems can offer to many patients. We have therefore agreed a realistic timescale to improve digital access for patients, building on improved infrastructure to firstly be able to book an appointment and access to their own records online, before progressing to video consultations for all in 2021. We will also set in train an important programme to digitalise all remaining paper records, so freeing up much needed space in GP practices as well as delivering a comprehensive electronic patient record.
And while patients will now have access to their own records digitally, we have secured £20m a year to cover the costs of subject access requests, which GPs and their teams have been having to complete unfunded since the introduction of GDPR legislation almost a year ago.
The Long-Term Plan established spending for the next 10 years, and after listening to the BMA for the first time, NHS England committed to increase funding for primary and community care at a greater rate than the wider NHS budget. After years of derisory pay uplifts for staff and tightening financial pressures on practices, this means we have been able to negotiate a five-year deal guaranteeing investment that covers pay and expenses, and at least matches predicted inflation. “Crucially, this investment has enabled us to fulfil one of our key aims by once and for all banishing the personal expense of indemnity cover, with a state-backed scheme set to begin, as promised, in April. This will mean that all GPs and practice staff, both in and out of hours, will be covered and represents a major change, freeing GPs from the significant risk of rapidly rising indemnity costs.
This package sets us on the road to rebuilding not only general practice but also the wider primary health care team; delivering an expanded workforce embedded within practices and giving GPs a leadership role in bringing together the community healthcare team.
These changes present a real opportunity to demonstrate that GPs will lead the development of a more resilient community-based health service for the benefit of our patients for years to come.
Dr Richard Vautrey is chair of the BMA’s GP Committee
