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GPC negotiators were ‘consulted’ on new GP contract, says NHSE GP lead


new GP contract


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.’

Previously, the BMA told Pulse it is considering its ‘next steps’, after a now-resigned GPC negotiator called for a vote of ‘no confidence’ in NHS England leadership.

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’.

READERS' COMMENTS [24]

Stephen Aras 4 March, 2022 3:20 pm

If true this was not done in my name nor that of my partners. I’ll not be a BMA member for much longer if this is their stance – Done up like a kipper methinks!

Simon Ruffle 4 March, 2022 3:22 pm

seek information or advice from (someone, especially an expert or professional).
“if you consult a solicitor, making a will is a simple procedure”
Similar:
ask
seek advice/information from
take counsel from
call on/upon/in
turn to
have recourse to
pick someone’s brains
have discussions with (someone), typically before undertaking a course of action.
“patients are entitled to be consulted about their treatment”
Similar:
confer
discuss
talk
talk things over
have a talk
exchange views
have discussions
converse
communicate
parley
deliberate
debate
negotiate
chew the fat
powwow
have a confab
talk turkey
palaver
put their heads together
confabulate
consider
have regard to
respect
have an eye to
refer for information to (a book, diary, or watch).
“she consulted a large desk diary”
Similar:
refer to
turn to
look something up in.

I have now consulted with the readership of PULSE about the meaning of consulted.
Means nothing. Do not be fooled trying to increase the disconnect from GPC exec, to GPC, to grassroots GPs has been succeeding, despite being a critic of how things have been happening I am not falling for this bovine wastage.

David Melville 4 March, 2022 3:25 pm

Consultation means we ask you what you think, but we plough on regardless. Look at all the ‘consultations’ on hospital closures etc. Clearly the process did not include negotiation. Suggest all salaried GPs put a line through any contract that says you have to work weekends etc. If imposed just walk and tender work back at punitive prices, it cannot succeed without a willing workforce.

Barry Moyse 4 March, 2022 3:27 pm

I expect Dr Kanani sent the GPCE a WhatsApp?

Paul Evans 4 March, 2022 3:40 pm

Consulted.

Just as workers about to get laid off from a factory are consulted.

Or homeowners whose properties lie in the way of HS2 are consulted.

Dr K maintains her form of doing what NHSE say, when they say it, whilst telling us that she cares about us.

Darren Tymens 4 March, 2022 3:46 pm

D Kanani seems very, very out of touch.

Tim Atkinson 4 March, 2022 3:55 pm

NHSE consultation process:

“We’re going to do X.”
“Er, we don’t like that.”
“Well we’re doing it anyway. You have been told.”

David Church 4 March, 2022 3:56 pm

So, is this Doctor truthfully stating that the GPC negotiators were asked in 2019/20 to agree that GP surgeries would be open for routine work on Satrudays from 2020, whether or not there was a Pandemic of Covid, and that those GPC negotiators agreed that routine saturday working would occur, even if there was a pandemic ? Or is this not the case?
Sounds like another case of the Contagious Hair Infestation.

David Church 4 March, 2022 3:57 pm

sorry, Saturdays from 2022, not 2020 !

Patrufini Duffy 4 March, 2022 4:12 pm

Consultation via Twitter. An emoji.

Remember, not everyone at medical school was your friend. Far from it.

Patrufini Duffy 4 March, 2022 4:15 pm

Dr K is the prodigy of Dr Arvind Madan. You know, one of the Prof Field, Hunt etc. lot. Don’t expect much. A medium for Hancock and now Javid. Not everyone at medical school was your friend. Remember that.

Finola ONeill 4 March, 2022 5:16 pm

I hear lots of words. The answer is still the same. Ditch the PCN Des. Heads down. Refer everything we need to, as normal, to secondary care. A&E and OP as per clinical indication and need. Do not engage in changing your practice too accommodate secondary care deficits. It doesn’t change what is needed. Do not engage in the “phone a friend” advice and guidence unless you feel that is best management for your patient using a case by case basis. Make referrals and treatments based on your experience, what is clinically indicated and what the patient needs. Ignore everything else. Everything else is NHSE’s problem. Keep calm and Carry on. And Ditch The PCN DES.

Richa Singh 4 March, 2022 5:19 pm

It’s unbelievable the “ pulava” being created. If the contract was “ consulted or agree” in principle in 2019 – it’s clearly not applicable status quo as Pandemic has happened in between in case NHSE has not noticed. GP’s are struggling to deal with the workload as it is majority of which is occurring due to Secondary care either rejecting/ delaying referrals or dumping work on General Practice. During the pandemic we DIDNOT STOP unlike other services. This just seems like another attempt to run General Practice aground. Private providers- you wouldn’t have to wait too long!

David Jarvis 4 March, 2022 5:26 pm

Well if she thinks the £7.44 is more than enough she can crack on. Look how that worked for the OOH’s being cheaper at scale than those profligate waster lazy money grabbing GP’s. I have zero interest in doing any more work as am maxed out on tax ceiling.
I can’t wait to see how her Saturdays are going as I’ll be down the pub or rugby club.

Adam Crowther 4 March, 2022 8:11 pm

Perhaps Dr K would like to subcontract the extended access service for the whole UK if can do for just over £3 pp. in fact consider £3.50 a bumper rate. Of course if the terms are breached then we reserve the right to compensation of 10 x the contract value

Turn out The Lights 4 March, 2022 9:09 pm

She and NHSE are so full of it,While we can smell the BS they can’t smell it themselves.Good luck trying to get a demoralised workforce to do what you want you will be as successful as Putin and his army getting conscripts to fight in the Ukraine.Sometime In think NHSE as gone to the same school of man management.

David Jenner 5 March, 2022 9:15 am

Dr Kanani needs to report how much money has been withheld already from the contract due to under recruitment to the ARSS scheme and returned to the treasury.
Funny how NHSE can agree variations to the PCN DES to help us cope with the pandemic last year but not now .But as Fiona says the PCN DES is not compulsory and you can resign it .
BMA were undoubtedly naive in agreeing the five year contract and totally wrong in not offering us an opportunity to vote on it at the time
BMA ,time for an emergency meeting LMCs or a ballot on industrial action please .

David Banner 5 March, 2022 9:48 am

So the BMA and GPC were either ignorantly naïve or conniving Vichy collaborators. Either way they have proved not fit for purpose.
Reject the DES and soldier on.

Samir Shah 5 March, 2022 1:19 pm

‘GPC negotiators were ‘consulted’ on new GP contract, says NHSE GP lead’….you wouldn’t expect Dr K to say anything other this drivel. It’s her job. She’s not your friend, despite the smiley emojis.
NHSE doesn’t seem to show respect the GPC, nor BMA. They don’t think they represent General Practice anymore.
Are they correct?

Kate Harvie 5 March, 2022 3:22 pm

“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.”. Is she really trying to say that NHSE had to impose this and had absolutely no choice in the matter? This is unbelievable!

Nicholas Grundy 5 March, 2022 5:17 pm

Can you imagine if we suggested treating patients like this?

“Well, Mrs. Jones, you agreed to this treatment in 2019, so I don’t care that you now don’t want it – I’m going to impose it on you, and consider this consulting with you about it.”

The handwringers and oh-it’s-terribly-difficult-for-us tribe nationally would blow a collective gasket, quite rightly. But apparently it’s fine for them to treat us in this way.

This smells exactly the same as when Dr. Kanani’s predecessor, Arvind Madan, was making earnest public statements about how intent NHSE were to support smaller practices, while privately saying we should be pleased when they closed down.

NHS England aren’t worthy of our trust. Haven’t been for years.

Nicholas Sharvill 5 March, 2022 5:35 pm

Staffing. As a non salaried/non partner working for an organisation providing’ enhanced access (think this week this is what it is called) whether I work Tuesday or Saturday makes little difference BUT on Saturdays we have no nurses for dressing , spirometry, ear syringing, blood tests etc so as the ‘full normal GP service is expected this means less service Monday to Friday as there are no more staff.== same patient throughput but headline news for politicians. The potential good news though is the NHS is taking over all GP premises so they will provide running costs for the extra hours.As one who worked as a GP when we were always open on Saturday mornings I can say the demand was not exactly high.
I suspect those who are being subject to abuse abuse in columns are in a very difficult place. Agree they did not have to take on the role but someone is driving n agenda that will end up with Private GP springing u all over the place, just like dentists as the NHS provision becomes harder to navigate . We have already seen the contractual role of the CCG to provide a NHS dentist if asked quietly removed, handed to NHSE who do not see it as part of their role.

Can some GPs from the quoted services run by hospital trust please speak up

Patrufini Duffy 7 March, 2022 2:36 pm

Ditch the PCN
Those of you in it hold a grenade in your surgeries.

David jenkins 10 March, 2022 12:09 pm

reminds me of a few years ago.

ken clarke tried to impose a new contract on us. he was told “the letter of the law says you must negotiate”

so he arranged a negotiation between 11am and midday on a monday (at short notice) obviously.

at midday he announced “right, i’ve had a negotiating meeting, the law is satisfied, – this is what is going to happen on april 1st”.

it did, and i busted my arse to pay my practice mortgage off – then left.

i’m now debt free, still doing locums at age 72, and i’m as happy in my work as the proverbial “pig in shit”

i urge you all to get rid of your debt as soon as you can – you can then plan the rest of your life. there’s plenty of work out there, just a different way of doing it. choose your own rates of pay, t’s and c’s, holidays, days off, where and when you work, etc., no silly diktats, no “post verification” snooping, just see the patient (like you were trained) then go home.