#GPnews: ‘This is not a rescue package’

17:15 This evening we are leading on a big story that has emerged from today’s publication of the General Practice Forward View. 

NHS England is not going to cover GP indemnity costs as part of the Foward View rescue deal, despite calls from the profession to do so, instead focusing on a ‘discussion’ to address rising fees. 

Read the full story here

15:30 Elsewhere, the chair of Doncaster LMC Dr Dean Eggitt has expressed how ‘suprised’ he was to see that the RCGP was ‘so supportive’ of the General Practice Forward View, adding that he believes it is certainly ‘not a rescue package’. 

In a letter to GPs in Doncaster, Dr Eggitt went on to add that the profession needed to be cautious and recognise that the document lacks in substance in providing solutions to the core problems general practice faces. 

‘We need to be cautious and recognise that the document does not provide any details on what the solutions to our problems are and how any solutions may be implemented. So I was very surprised to see that Maureen Baker and the RCGP have been so supportive of this document’, Dr Eggitt said. 

‘GP Forward View is certainly not a rescue package for General Practice and I will save my celebrations for later.’ 

15:00 Speaking of Mr Simon Stevens, chief executive of NHS England, it appears he got his calculator out before signing off the GP Forward View – or, perhaps, his recent copy of Pulse.

In the foreword to the 60-page behemoth, Mr Stevens admitted that the NHS has ‘a long way to go’ to make a reality of the Government’s ambitious pledge for there to be 5,000 more GPs by 2020.

As revealed in a Pulse analysis last month, it is unlikely to reach even half of this target.

Of course, since then we have learned that NHS England is hiring ‘at least’ 500 qualified GPs from overseas, which Pulse was also first to reveal.

But, like Pulse, Mr Stevens seems to have realised that the figures don’t quite add up.

Mr Stevens said: ‘We all accept that we have a long way to go to hit the ambitious recruitment targets set for primary care, but we must use every effort to try, as this will be necessary for much of the reform required.’

14:40 Pulse blogger and GP campaigner Dr Zoe Norris made an appearance on TV this morning, being grilled by the BBC’s Victoria Derbyshire for her reaction to the GP Forward View. True to form, she made good use of her few minutes of airtime with her other guest, RCGP chair Dr Maureen Baker.

Dr Norris said her concern with the support package was ‘timescale’, with little in the way of urgent remedies to ensure there was still NHS general practice ‘in six months’ time’.

Asked what she would ask for if she could have had anything, Dr Norris said she wanted CQC inspections and revalidation to be at least temporarily suspended, and for GP indemnity costs to be reimbursed. That told you, Mr Stevens.

14:00 Something you might have missed.

The review of the Carr-Hill formula, which adjusts global sum allocations to GP practices based on patient demographics, is to finally conclude this summer, NHS England has said.

The General Practice Forward View said that this would lead to ‘fairer distribution’ of practice funding, including taking into account deprivation factors better.

The formula has been reviewed on and off since 2007 but no changes have as yet been implemented, with the review being reannounced in every recent GP contract settlement, with a string of missed deadlines.

The Forward View document said: ’Many believe that the Carr-Hill formula is now out of date and needs to be revised to reflect changes in the population and the impact of this on comparative workload.

’NHS England is working with the BMA to review the Carr-Hill formula to specifically examine the impact of deprivation, age and other factors that influence practice workload. This work will be concluded in the summer of 2016, and form the basis of discussion with the BMA about changes that might be needed.

The Carr-Hill formula applies a weighting to GMS funding to reflect the comparative workload associated with different patient groups.

12:35 Chair of the health select committee Dr Sarah Wollaston has tweeted today that she welcomes the General Practice Forward View and makes reference to the committee’s primary care report, which is out today, calling on the Government to ‘focus on the workforce to allow patients to have faster access and longer GP appointments.’ 

I welcome the #GPforwardview which addresses so many issues for patients raised in @CommonsHealth report out today https://t.co/KWIsbLKIjH

— Sarah Wollaston MP (@sarahwollaston) 21 April 2016

@sarahwollaston gives the main points of our report, published today into Primary Care. https://t.co/hH0lLt44OV pic.twitter.com/7KHSAkmpbx

— Health Committee (@CommonsHealth) April 21, 2016

11:35  Following today’s big announcement from NHS England that it will invest £2.4bn a year in general practice – which will see 10% of the total proportion of NHS spending going into primary care, another member from the GPC has had their say on the news. 

Chair of the GPC’s contracts and regulation subcommittee, Dr Robert Morley, has told Pulse that while it is good news that the ‘parlous state of general practice has belatedly been recognised’ – there is a ‘conspicuous lack of detail on exactly how any new money will be spent’.

Dr Morley told Pulse: ‘Whilst it’s good news that the severity of the parlous state of general practice has belatedly been recognised and that all additional investment and many of the specific measures heralded in the document are to be welcomed, the increased funding announced here is still far too little, too late to resolve the catastrophic workload and workforce crisis facing the profession.

‘And, typically, much of this is not new money at all, simply re-badging of previous announcements. Above all this is not going to deliver the increased workforce which is desperately needed to safely provide core general practice, let alone develop services to make them fit for the future. There is also a conspicuous lack of detail on exactly how any new money will be spent – I suspect much of it will have significant strings attached and, as always, will end up being frittered away on political priorities and gimmicks rather than on  best serving the needs of patients.’

Find out what other GP leaders have had to say about the General Practice Forward View

10:30  Dr Michelle Drage, chief executive of Londonwide LMCs, has attacked NHS England’s publication of General Practice Forward View, claiming it ‘falls short of what is needed to address the challenges general practice faces.’ 

‘Today’s announcement falls far short of what is needed to address the challenges facing general practice in the Capital and beyond. GPs are in a state of emergency. Patients risk losing their GPs unless pressures on general practice are dramatically eased. General practice is at breaking point. That’s not safe for patients or staff, Dr Drage added. 

‘Between bean counting, over inspection and rising costs London general practice has had enough. Sadly, the GP Forward View contains little new for GPs – mostly re-badging existing money and schemes.’ 

9:20 We will, of course, have much more comment and detail throughout the day. You can keep up to date witheverything here.

9:00 Not surprisingly, there is a lot of reaction around this morning, which is summed up here.

The BMA and RCGP have both given their support to the package.

However, there are some dissenting voices, mainly focusing on the lack of detail:

I am going through the document, have been for hours. So little detail as to make it meaningless https://t.co/PGp5VnBelb

— Stephanie deGiorgio (@DrSdeG) April 21, 2016

I dont think the plan is for GP to access this money. Its about the development of primary care **NOT** GP https://t.co/bE8n8ZeFoM

— DrDean (@DeanEggitt) April 21, 2016

Important @TheBMA GPC today, building on what we’ve achieved in #GPforwardview but also wary about lack of detail that needs far more work

— Richard Vautrey (@rvautrey) April 21, 2016

6:30 In case you missed it… NHS England announced its General Practice Forward View today. Try these news stories for your morning reading:

• General practice set for 14% increase in funding as NHS publishes support package
• Investment in specialist services for GPs suffering from burnout;
• 3,000 fully funded mental health workers to be placed in general practice;
• A range of measures to stop secondary care dumping workload on primary care;
• CQC scaling back GP inspections;
• Recruiting more than 500 overseas GPs

For more in-depth reading, we have:

• All the reaction here
• Simon Stevens: The bulk of this package is about supporting existing practices
• The document in full

There will be a lot more coming up throughout the day.