BMA demands ARRS money be given to GP practices to avoid further dispute
ARRS money should be moved into practice-level reimbursements to avoid GPs re-entering dispute with the Government over the 10-year plan, the BMA GP committee has demanded.
In a letter to primary care minister Stephen Kinnock, GP Committee England chair Dr Katie Bramall also demanded the Government is ‘explicit’ in its preference for GPs to run neighbourhood services, amid serious concerns that the plan threatens the survival of independent practices.
Other demands include the Government providing confirmation around funding for GMS in the next financial year and for a new GMS contract to be in place by 2028.
As revealed by Pulse, the demands followed a motion at GPC England raising concerns about the lack of progress on a new GMS contract, and the content of the 10-year plan. Mr Kinnock had attended the meeting earlier in the day.
The GPC was asked to consider re-entering dispute with the Government ‘with immediate effect’, which Pulse understands was taken as a reference, although they did leave the door open for further disputes.
The GPC’s previous dispute with the Government over pay and conditions ended in March, following a written commitment from the Government to negotiate a wholesale new GMS contract within this Parliament.
However, the 10-year plan does not mention a new GMS contract for general practice, only two new contracts for neighbourhood services which ICBs will be able to award to other providers, including NHS trusts.
Dr Bramall’s letter said: ‘I would emphasise [the committee’s] disappointment and confusion around the Government’s failure to explicitly commit or even mention the delivery of a new GMS contract within the plan’s pages.
‘So, whilst it was reassuring to hear your commitment to protect both NHS GMS renewal and to renegotiate the national contract with GPCE within this Parliament (as set out by the secretary of state in his letter of 18 March 2025), we will judge this Government, as you say, “by its results”.
She warned Mr Kinnock that the Government should not ‘underestimate how alarmed GPs are’ by ICBs and trusts ‘aligning at pace to secure influence at a neighbourhood level’.
It comes after one large London ICB has already chosen a number of hospital trusts to oversee the new ‘neighbourhood health service’ across its footprint.
Dr Bramall added: ‘There is a risk this will leave GP organisations behind; especially given the tight timescales on lengthy application forms.
‘The same concern is true with ill-equipped systems racing to form integrated health organisations.
‘You heard first hand elected members’ concerns around vertical integration at scale, which could potentially result in foundation trusts holding a registered list replacing traditional GP services.
‘There is a growing consensus across the profession that the current trajectory threatens the survival of the independent contractor model and, with it, NHS general practice and the trusted family doctor relationship our patients rely on and want to protect.’
The demands in full
GPC England requests:
- Confirmation of the funding envelopes for GMS 26/27 and the new GMS negotiation, together with SNP and MNP nominal budgets in this Spending Review
- A roadmap regarding timelines for commitment to GMS contract renewal and investment
- Transfer of the Primary Care Network Directed Enhanced Service Additional Roles Reimbursement Scheme monies into practice-level reimbursements with defined neighbourhood outcomes from April 2026
- An emergency additional GP practice-level reimbursement scheme to reduce GP under/unemployment as soon as possible
- Extension of the Clinical Negligence Scheme for General Practice to cover liabilities pertaining to data-sharing and information governance for the GP patient record from April 2026; and
- That Government is explicit in its preference for General Practice / GP practices to lead single neighbourhood providers and to be the key parties at Place in the selected National Neighbourhood Health Implementation Programme sites.
Source: GPC letter
Health secretary Wes Streeting has previously argued that as part of a radical reform of the NHS, acute trusts should be able to provide primary care services and that ‘successful GPs’ should be ‘able to run local hospitals’.
However, following the publication of the plan, NHS England’s primary care director had said that hospital trusts will be invited to take on new contracts for neighbourhood services where GPs ‘are not stepping up’.
And the RCGP recently opposed plans for acute and community trusts to run general practice.
The 10-year plan announced the introduction of two new contracts as an ‘alternative’ to GMS, aimed at enabling GPs to work across larger geographies, delivering enhanced services for people with similar needs or focusing on services that require coordination across multiple neighbourhoods.
But following the announcement, GP leaders and experts have raised concerns that these contracts could mean the end of the partnership model.
The GPC motions
That this committee, in the absence of any meaningful progress by the Secretary of State toward his promise to deliver a new core GMS contract to replace the current chronically underfunded GMS contract, believes that the Government’s “10 Year Plan” for the NHS poses an existential threat to the independent contractor model of General Practice, and:
(i) Instructs GPCE officers to develop a list of non-negotiable demands which should include at least £50 per patient extra per year into core GMS to “restore the core”
(ii) Warns that this plan will force loss of individual GP surgeries and bring about the death of the trusted “family doctor” model of care, representing an unapologetic broken manifesto promise by this government
(iii) Believes that the plan’s focus on horizontal and vertical integration at scale will result in either greater control by large private sector corporate providers; or by hospital trusts with no evidence of effective General Practice service provision Carried
That GPC England notes the visit from the Minister for Care, but still has profound concerns regarding the
inherent threats within the Government’s 10 Year Health Plan to the independent contractor model of general
practice, and:
(i) Calls for GPC England to design and deliver a patient-facing information campaign warning of the risks posed by vertical integration and integrated health organisations, where foundation trusts may hold a registered list replacing holistic, cradle-to-grave care with built-in continuity offered by traditional GP partnerships
(ii) Recognises that many practices and GP-led organisations may feel they have little choice but to engage further with their ICB’s plans, and in this context calls upon the GPC England officers to urgently create guidance for “ethical” frameworks of well governed GP-led at scale organisations where surplus must be reinvested back into member practices’ staff and services, in order to protect the independent contractor model of GP practices
(iii) Is concerned that the Secretary of State risks breaking his written promise to the profession of 18th March of a new GMS contract within this Parliament, and instructs the GPC England officers to immediately write, informing him what is required by the time the committee next meets, to avoid facing a return to dispute
Carried
Source: GPC letter
