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What are the GP contract changes for England from April?

  • The total funding uplift will be £256.3m, or 3.4%, from 1 April.
  • This is intended to include a 1% uplift to GP pay and a 3% uplift, in line with the consumer price index, to cover practice expenses inflation.
  • A further uplift may be made following the Government’s response to any recommendations by the Review Body on Doctors’ and Dentists’ remuneration (DDRB), expected in May 2018.
  • It also includes £60m to practices to cover the cost of indemnity inflation; an uplift to the item of service fee for certain vaccinations and immunisations from £9.80 to £10.06; a £22m uplift to allow a change in the value of a QOF point as a result of the contractior population index adjustment; and a non-reccurent £10m investment to recognise additonal workload of implementing e-referral contractual requirements.
  • The funding will be added to the global sum allocation with no out-of-hours deduction applied.
  • Funding to cover indemnity payments is unweighted. All other uplift payments are on a weighted basis.
  • The maximum figure practices can be reimbursed for locum costs will increase by 1%. Locum reimbursement for parental leave and sickness absence will be simplified.
  • The non-recurrent £60m indemnity cost reimbursement will be paid out to practices this month, mirroring last year’s process. It is intended to cover the increased costs for 2017/18.
  • This comes as negotiations continue regarding the state-funded scheme due to start in April 2019, covering all GPs (contractors, salaried, locums and trainees) and all practice staff for NHS work.
  • NHS England and GPC have reached an agreement on the update to the 2013 Premises Cost Directions. However they agreed more work is necessary – and a six-month review is due to start in the summer regarding GP premises, also including the Department of Health and Social Care.
  • The parties will also continue their review of QOF.
  • NHS England and GPC agree that NHS-commissioned practices must not advertise private providers of GP services which the practices should be providing free of charge on the NHS.
  • There will be a contractual change so that practices that have not achieved a minimum of 10% of patients registered for online services – online ordering of repeat prescriptions, online appointment booking or online access to patient records – will work with NHS England to help them achieve greater use of those online services.
  • A ‘violent patient’ flag against a patient record will constitute reasonable grounds to remove them, and practices which has mistakenly registered a flagged patinet will be able to deregister them by following the same procedures as for removing patients from a practice list who is violent.
  • The average practice list size (CPI) had risen from 7,732 as at 1 January 2017 to 8,096 at 1 January 2018. As such, the value of a QOF point will increase by £8.06 or 4.7 per cent from £171.20 in 2017/18 to £179.26 in 2018/19.
  • No QOF indicators have been removed and there are no changes to thresholds.
  • There will be further talks about checking migration status of patients for 2019/20.
  • NHS England, GPC, NHS Digital and system suppliers will work together to facilitate appropriate collection, analysis and use of anonymised, standardised appointment data, to better understand workload pressures in general practice.
  • CCGs will develop and provide funding for appropriate local social prescribing services and systems, with input from LMCs.
  • The new ‘Freedom to speak up’ requirements will apply to general practice, within an agreed format, coming in no later than 2019.

Source: NHS Employers