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The waiting game

Unplanned admissions DES to be renewed under new GP contract deal

The 2015/16 GP contract deal renews the unplanned admissions DES for another year, extends the online services offered to patients and introduces a ‘named GP’ for everyone.

The deal - announced today by NHS Employers - also includes the publication of net GP earnings, a 15% reduction in seniority payments and improved paternity and maternity arrangements for practices in England.

The GPC says the deal will provide ‘stability’ and ‘much-needed breathing space’ for practices, with no changes to the overall size or value of the QOF - although discussions over whether some of the clinical indicators should change are ongoing.

The deal also scraps the patient participation DES and the alcohol DES; they will become contractual requirements and the associated funding used to boost global sum.

It also promises a ‘strategic discussion’ over GP premises and that NHS England and the GPC will ‘work together on workforce issues’.

The main changes include:

  • A named GP for all patients, including children, with a simpler requirement to inform patients at the ‘next appropriate interaction’.
  • Patients will be given online access to all coded information in their GP records online, but not free text. A larger proportion of appointments will be available to book online and GPs will also be required to offer patients email access to the practice.
  • The unplanned admissions DES will be renewed, but with the reporting template cut by half. Care plans for patients who die or move away will now count within the 2%, and those who received one during this year will have to be reviewed, but will not need a completely new care plan. A new ‘patient survey’ will be introduced.
  • Funding for locum cover for GPs on maternity and paternity will become an ‘automatic right’ for all practices.
  • No changes to the size or value of the QOF, although discussions are continuing over the NICE menu of changes to clinical indicators. Plans to hike thresholds have been put on hold for another year. Point values will be adjusted to take account of population growth and relative changes in practice list size
  • There will be a 15% reduction in the total seniority payments as agreed in 2014/15
  • GPs will be required to publish their average net earnings on their website by March 2016, although non-contract earnings will be exempt.

GPC chair Dr Chaand Nagpaul said the negotiations had been ‘tough’ but had resulted in an agreement ‘which gives general practice a much-needed breathing space and greater stability for practices and patients’.

He said: ‘We have secured changes aimed at freeing up GPs’ time and improving patients’ experience of general practice.  Measures to reduce bureaucracy, and allow family doctors to spend more time with patients are a step in the right direction.’

Mr Hunt said: ‘GPs are the bedrock of the NHS and by bringing back a named accountable GP for everyone we will strengthen the relationship between GPs and their patients.’

‘I understand the pressures that general practice is facing with an ageing population, but we want make sure that all patients get personalised care tailored to their physical and mental health needs, supporting people to live healthier lives.’

Dame Barbara Hakin, national director for commissioning operations at NHS England, said: ‘Our vision is to see general practice play an even stronger role at the heart of local communities, offering more joined up and proactive care for patients. This is vital in addressing the rising demands on NHS services.

‘Today’s contract changes recognise that and most importantly are aimed at improving care for patients.’



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Readers' comments (24)

  • So several things that are now voluntary and we get paid for doing, become a contract requirement that we don't get paid for.
    Welcome to the nasty world of Jeremy Hunt, where voluntary becomes mandatory and the funding for doing it is removed.

    Is there absolutely nothing on this earth that will make the GPC stand up and say enough is enough? How is the progress towards your name being in the Queens Honour's list Dr Nagpaul?

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  • This is an unworkable plan; no real gains for patients, too bureaucratic

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  • Patients already have a named Usual GP what's new there. And now having spent some considerable hours of input with our Patient Reference Group I have to do it for nothing........ Surprised!! I'm not. As for the rest its just doing more for less with no tangible patient benefit.
    All the goodwill in General Practice has long gone, my flexibility is flexed out. Roll on retirement and that's just the Practice Managers perspective.

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  • Why have a GPC to have this s*** enforced on us by the government ANYWAY?
    As usual things which were paid for are now compulsory- PPG, alcohol DES for example.
    Primary Care is truly screwed.
    On a good note it will help make up their minds FOR those who are wavering on quitting NHS!!

    Unless GP`s decide to do something we will face more of this.

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  • This comment has been moderated.

  • Why, oh why? This is what doctors do anyway, minus the bureaucracy. As the first commentator said "So several things that are now voluntary and we get paid for doing, become a contract requirement that we don't get paid for. " It' s almost impossible to get paid for this DES and it's bringing us to breaking point.

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  • Yet again, changes are made without consultation with any of us at the coal face......I thought it would be perfectly reasonable to allow doctors to do the job they are trained to do, rather than become consumed by paper, audit and tick box medicine! And I hear that David Cameron has promised that everyone will have access to their GP 7 days a week if they are elected next year.....well don't you know already David, patients can see a GP 7 days a week - just not the one they WANT to see..!! When will Government learn that constantly moving the goalposts will do nothing but undermine the work we are doing already - AND newly qualified doctors will resist coming into General Practice as they are already doing. If he wants to completely erode the work of Primary Care, he is doing a really good job.
    Now, can someone please help me down from this high horse......?!!

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  • If GPC think the GP practices are stable they need to get down from lala land.
    I dont blame the GPC for this , they were forced a bad contract but GPC should call for a strike rather than agree.

    Unless we strike this is going to continue,a lternate is to overperform on drugs and referrals.

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  • Peter Swinyard

    Is it not time to start a fightback against contract creep? We have a reducing workforce and reducing resources. Who is to provide all these services free, gratis and for nothing?
    As a shortage commodity, we do at least have a stronger negotiating hand than for some years.
    I know Chaand Nagpaul is the strongest voice we have had for general practice for some time - and snide comments about his ulterior motives are both wrong and unnecessary - and we all need to be behind him in fighting for proper patient-centred family medical practice based on continuity of care and traditional family doctoring in a modern idiom.
    Don't let the BMA heirarchy (who are NOT mainly supportive of GP) stifle his and the negotiators' reasonable pleas for resourcing general practice correctly.
    Do fight for restoration of the primary care share of the NHS budget from 7.5% to 11% of the NHS cake for the 90% of consultations which are done in general practice.
    This negotiating round is at election time - we should be able to make some progress - and I hope the list in the article is the NHSE wishlist, not the agreed final solution

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  • I am afraid that is the agreed list Peter.
    The funding for the DES is due to be rolled into the global sum although it is not clear if it is the whole potential payment or just what was paid last year.

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  • We wont' earn anything from this DES as it's so ridiculously specified. Why don't they wait to see who delivers anything before deciding to roll it over.

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