GP negotiators will demand QOF, IIF and PCN DES monies are all moved into one simplified core general practice funding stream in new contract discussions.
In a ‘call to action’ document setting out points for contract negotiations, the BMA’s GP committee called for a unified contract with all funding coming through one route with sufficient resource to enable practices to deliver core services.
The GPC also called for QOF, IIF ‘and all other micro-targets’ to be scrapped along with the PCN direct enhanced service which had proven to be ‘a failed project’ to be replaced with a quality improvement-based contract.
This also means removing general practice from the CQCs remit, the document which forms a basis for a new negotiated contract, noted.
‘Quality monitoring and regulation of contracting must be light touch with low levels of bureaucracy’, it said.
The 2024/25 contract negotiations will be the first since the end of the five-year deal.
GPC England urged doctors to join the BMA ahead of a potential ballot over industrial action if 2024/25 contract negotiations turn sour.
On working at scale, the BMA said practices should be encouraged to work collaboratively but only on services that need to be provided at scale and all practice level activity should be contracted and resourced at that level.
As part of this ARRS staff should be ‘redeployed to support the provision of core general practice care as their primary function’, the BMA said.
And GP practices should be the preferred provider for all clinical services commissioned in general practice ‘that would ordinarily be provided by general practice’.
‘Government must remove any bureaucratic hurdles, box ticking and targets that are not clinically necessary, and take GPs away from providing quality care,’ the BMA said.
‘Government must agree a contract that trusts GPs to deliver the care they are trained to provide and know their patients need,’ it continued.
There also needs to be agreement between Government, NHS England and the profession nationally on communication to patients ‘on what they can reasonably expect their practice to provide’ and that this by fully resourced, the call to action said.
Safer working recommendations should be adopted by all practices and supported by NHS England ‘with capping of contacts universally applied to ensure safe patient care’.
On workforce, a fully resourced and immutable seven-year plan is needed to bring numbers of full-time equivalent GPs up to at least 40,000 by 2030/31, it said.
In addition, continuity of care must be a priority in the design and funding of GP as recommended by the Health and Social Care Committee and RCGP.
Other principles include:
- Transfer of unresourced workload from other providers to become a ‘never’ event, with systemic measures in place to review, fund and resolve breaches
- Recognition and support for the independent contractor model as the best and ideal mechanism for the provision of practice-level contracting
- Fully funded long-term premises plan to be prioritised as well as fully-funded and future-proofed modern IT solutions
- Safer working recommendations to be adopted by all practices with capping of contacts universally applied
- Recognition, measurement and management of all work undertaken by GPs in general practice.
Dr Richard Van Mellaerts, deputy chair of GPC England at the BMA, said: ‘Our Call to Action document has been created for GPs by GPs, and outlines GPC England’s existing policy asks about what the profession needs in order to provide high-quality care both now and in the future.
‘This includes an ask for the Government to abolish the nationally micromanaged PCN DES and instead move all funding and resources into core general practice contracts.
‘The BMA believes that leaving collaborative neighbourhood working to practices to evolve collectively, under a reformed national contract, means that local patient needs can actually be prioritised – rather than hitting arbitrary, bureaucratic targets that don’t serve a particular community and only increase unnecessary GP workload, which takes them away from direct patient care.
‘Ahead of contract negotiations, we hope this document serves as a roadmap for how to secure the future of general practice, because it’s clear that the current system isn’t working. Not for GPs and certainly not for their patients.’
nice idea but wont happen
Well done BMA /GPC
Clinical Directors have abjectly failed at huge cost to patients and cost to Primary Care in general but at huge benefit to themselves.
There will be no difficulty in this group of board hoppers jumping onto to another highly paid most likely unnecessary board position.
PCNs are the most disgraceful waste of resources in NHS history with the introduction of poor monitoring processes and work which could easily have been done from within practices at much lower cost from the outset with a high level of preventable damage caused to patient care difficult to otherwise imagine and yet unknown to the public.
The level of salaries paid to some relatively junior PCN and on occasion unqualified staff would be eye wearing to the general Public.
I expect the government and Clinical Directors to resist the need for common sense and for better use of NHS funds, but the BMA/GPC should press on
This is professional leadership and would rescue general practice if implemented. It is what is needed. The days of accepting the least worst option have incrementally led us to this situation. Well done for standing firm.
We will see. It sounds great.
I am ever the optimist but after being a partner for over a decade now I very sadly believe that Whitehall dinners, political careers and nepotistic deals will scupper every single part of this.
This is an excellent set of principles to base the last stand of General Practice around.
It will flush out with complete certainty the direction of travel to end the existence of independent General Practice.