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Exclusive: Next year’s GP contract will be ‘stepping stone’, says NHS England director

Exclusive: Next year’s GP contract will be ‘stepping stone’, says NHS England director

Exclusive NHS England is ‘not in a position’ to negotiate to a new five-year GP contract due to a lack of a funding commitment, with the 2024/25 contract set to be a ‘stepping stone’, Pulse can reveal.

In an exclusive interview with Pulse, national director of primary and community care services Dr Amanda Doyle said ‘it is almost certain’ that they will not be negotiating a new five-year contract starting next year.

She said that this is because NHS England only has a one-year funding settlement for 2024/25.

The current contract runs out in 2024, and it had been thought that the 2024/25 would herald a seismic change in general practice in England, similar to the 2004 contract that removed out-of-hours obligations from practices.

There have been radical suggestions from both sides of the negotiations, including moving to payment by activity, scrapping QOF and introducing contractual workload limits.

However, in the exclusive interview with Pulse, Dr Doyle suggested that the next contract was going to be a one-year deal.

Dr Doyle told Pulse: ‘As you know this is the final year of the five-year contract framework that started in 2019. The reason that we were able to put a five-year contract in place, was that we had a five-year funding settlement from 2019 to 2024.

‘We only have a one year funding settlement for 2024/25 and so it is almost certain that we won’t be negotiating another five-year contract.

‘What we want to do is see what we can do in 2024/25 as a stepping stone to take us in the direction of travel that our strategy directs.

‘But we are not going to be in a position to commit to a five-year contract.’

In March, NHS England imposed a contract on GPs which included more stipulations around access, but no extra funding.

The main changes included GP practices having to offer patients an ‘assessment of need’ on first contact and ‘no longer being able to request that patients contact the practice at a later time’.

The BMA’s GP Committee had previously rejected the contract offer, labelling it as ‘insulting’ and warning that it would risk the safety of patients and cause more GPs to leave.

However, in April the GPC voted against organising industrial action over this year’s GP contract imposition, holding off while it sees how negotiations over next year’s deal turn out.



Please note, only GPs are permitted to add comments to articles

Bonglim Bong 10 August, 2023 12:12 pm

Sounds like NHS England need to make sure the Department of Health is involved in the contract negotiations – they do take part.
And if that is not good enough get Rishi himself involved.
And if that is not enough get both Rishi and Kier Starmer involved together.

Saying we can’t do it properly is just not acceptable.

David Church 10 August, 2023 1:21 pm

Is this meant to be a signal to GP Practices not to take on any further staff on permanent employment contracts or Partnerships, because NHSE is about to pull the rug?

Nathaniel Dixon 10 August, 2023 2:11 pm

Fine no long term investment then, sure that’s not important anyway….

David Jarvis 10 August, 2023 2:32 pm

This is a classic dump on the next elected government. Further short termism after 13 years in power.

David Jenner 10 August, 2023 3:03 pm

David jarvis has it right
No political will to try too hard on this knowing a General Election pending
Expect them to offer more of the same and minor tweaks
To the contract but this is of course the time for BMA under new management to get feisty.
Carpe diem GPC

Richard Greenway 10 August, 2023 3:03 pm

Distrustful of any statement with the words “direction of travel” in it

Darren Tymens 10 August, 2023 3:31 pm

The last 5 year contract has been a disaster, not least because our negotiators failed to take inflation into account (an unforgiveable and amateurish error), gave way too much away for too little return, and undermined the fundamental interests of general practice by introducing PCNs in the form they did.

We are overdue a major contract overhaul. Along the lines of 2003/4, a new one needs to be properly reimbursed and link payment to workload. Setting core investment in general practice at 11.5% of the NHS budget hardly seems unreasonable, along with reducing NHSE micromanagement, and reducing or stopping unevidenced regulation.

The political situation means NHSE are in limbo, at least in some senses. But that shouldn’t stop NHSe from introducing positive change – if they are minded to do so. We historically used to have annual renegotiations rather than 5 year deals. Nothing stopping NHSE working within their existing agreed budgets whilst shifting investment away from hospitals and towards general practice. Nothing to stop them putting PCN money into core and letting us employ the staff we need. Nothing to stop them putting QOF money into core (though TBH I quite like QOF when evidence based and clinically worthwhile). Nothing to stop them making changes to make hospitals and other providers do their own workload rather than try to shift it to us. Nothing to stop them making changes to make sure that shifts of work are accompanied by shifts of funding.

I suspect this is just weasel words because 1) they don’t know what to do, and 2) they don’t really want to do anything.

Michael Mullineux 10 August, 2023 5:34 pm

Stepping stone into the NHSE swamp and oblivion

The Locum 11 August, 2023 9:47 am

That’s a mill-stone not a stepping stone.
How the largest employer in Europe cannot plan ahead more than 12 months is just one of the problems aftftecting the NHS. ICBs taking their cut of funding next year with no consultation / recompence is another.
GPs dont get the option to take out short term contracts with staff, premises etc but they’re are almost daily expected to take more risks/ deal with complaints etc while being told to get on with it / stop complaining
Why would any doctor remain in the UK professionally- baffles me (I understand family etc)
DOI – I am in process of leaving UK to work elsewhere

Centreground Centreground 11 August, 2023 11:10 am

PCNs and Clinical Directors are responsible for the most reprehensible undermining of Primary Care in NHS history with Clinical Directors personally benefitting with huge payments which quadrupled during the pandemic for no extra work output and to the detriment of all other GPs.
The PCNs have been responsible for the largest foreseeable waste of NHS taxpayers money one could imagine and hence PCNs should be disbanded as a matter of urgency.
ARRs have not been controlled and although clearly some benefits such as pharmacists have been of benefit the continued acceptance of low performing and costly roles should be rectified with immediate effect. These roles would have been managed more effectively by core general practice.
The accountability for this disaster lies fundamentally with NHSE and in the monetary incentives given to Clinical Directors to allow this catastrophe to have occurred and this requires a thorough review.

Truth Finder 11 August, 2023 11:43 am

PCNs should be scrapped and the money redistributed to the surgeries saving on excess cost to clinical directors and useless meetings.

Rogue 1 11 August, 2023 11:45 am

A 4 or 5 year plan is too much of a mill stone as we have found out. Handcuffed to a contract with 2% increase way below the level of inflation. We need a maximum 2yr contract and someone that will actually fight for general practice, because the BMA certainly doesnt represent us! For us the IIF and ARS are both just a waste of money and effort
All this annual restructuring is just a waste of time and money (but gives those in management something to do).

David jenkins 11 August, 2023 4:27 pm

i would urge you to bust your a*se and reduce what debt you have. you should have already made inroads to this when interest rates were low. things are going to get worse. pay off your debts as soon as you can. then reduce your hours. if EVERYONE – and i do mean EVERYONE, goes down to four days a week, or less, joe public will realise it is THEIR problem. there is no point in busting your a*se working flat out – you will have a bigger tax bill with very little extra in your pocket to show for it.

i did this when interest rates were low – and i now do two days a week. i don’t want to do more. i enjoy work, but i don’t enjoy being told how to do my job by politicians who are not able or qualified to do the work i do, and i will not do it !

just a thought.

think about it – more time off, the same pay (if you factor in the amount you pay in interest/mortgage/car loans etc etc etc)

you might think i’m a smug bast*rd being wise after the event, but i promise you it is going to get worse – whoever wins the next election.

Dr No 12 August, 2023 1:21 pm

Seriously? Last chance saloon for holding onto THIS old-timer. Not sure I can wait another 2 years for clarity about the future of GP.