The BMA GP Committee’s negotiators were ‘consulted’ on the new GP contract changes for 2022/23, NHS England’s primary care medical director has said.
NHS England this week announced the GP contract changes for 2022/23, which said that PCNs in England would need to offer routine services between 9am and 5pm on Saturdays from October.
The GPC has said that it ‘did not agree’ to the updates and that it was ‘blindsided’ by NHS England with an imposed contract.
But at an NHS England GP webinar held last night, Dr Nikki Kanani stressed that the contract was ‘agreed’ with the GPC in 2019 – including the year-on-year updates – and that they were ‘consulted with’ again this year.
She told GPs: ‘One of the things that is really important to know is that this is a contract that was agreed with GPC England in 2019/2020.
‘And GPC England were consulted with on the 22/23 contracts, which includes additional investment over and above what we described in 2019 and 2020. So of course that consultation happened.’
Pulse approached the BMA for comment at the time but it refused to provide a response.
Following publication of this story, it published a statement on its website that said it is ‘totally misleading to claim that “GPC England were consulted” on these 22/23 contract changes but to fail to mention that the negotiators did not support them, have not agreed them and that they have been implemented by NHSE without the agreement of GPC England’.
The BMA added: ‘In the interests of transparency, we hope that the NHS England and Improvement primary care team will clarify their remarks to avoid any impression that NHSE has GPC England’s support or endorsement for these changes to the 22-23 contract.’
Also speaking at the webinar, NHS England interim director for primary care Dr Ursula Montgomery added that the ‘vast majority’ of the proposals were agreed ‘in principle’ with the GPC.
Dr Montgomery said: ‘This year, there really shouldn’t be much of a surprise in that the headlines of this were agreed in 2019/20.
‘The vast majority of these proposals are not new, they have been agreed in principle.’
GPs were also told at the webinar that NHS England wants to start ‘thinking beyond’ 2023/24, when the five-year contract comes to a close.
However, the ‘default’ position after 2023/24 is for the existing contract to ‘automatically roll forward unless it is changed’, Dr Montgomery said.
She added that NHS England will engage with GPs and other NHS organisations on how to support ‘high quality and accessible’ GP services as well as how primary care will work in ICSs, informed by GP Dr Claire Fuller’s stocktake that is due to report in the coming months.
And commenting on the GP contract update for this year, Dr Kanani said that some GPs were ‘expecting’ the changes, but that others have ‘rightly’ said they can’t continue working at current levels.
She said: ‘There are others that are rightly saying actually, “we are tired and we are fed up – and it’s been the most exhausting 24 months that we’ve ever had.
‘”How can we just be asked to do anything like continue the way that we’re continuing?”’
However, she added that NHS England is in a ‘really difficult position’ because the contract agreed in 2019 came with funding and if its requirements were to be reduced, funding would also be reduced.
She said: ‘I don’t think that that is a tenable position, given everything else that we need to do. So we have tried to keep it as straightforward as possible.’
Meanwhile, speaking about the new PCN access requirements, Dr Kanani suggested that PCNs should be able to deliver the service – which brings together the current £1.44 per head Network Contract DES extended hours scheme and £6 per head CCG-commissioned extended access services – for less funding than the combined £7.44.
She said that when she worked as a commissioner, she was able to deliver the CCG extended access service for ‘just over half’ of the allocated £6 per head.
It remains unclear whether the DES will set out PCN funding of £7.44 per head for the service, as NHS England has refused to clarify to Pulse what funding PCNs will receive for delivering the scheme.
The service is due to begin from October as part of a new access offer within the network DES, but many questions remain unanswered – not least around funding.
The imposed contract was met with dismay across the profession, with grassroots GP groups calling for it to be ‘legally tested’.