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Revealed: What was in NHS England’s ‘insulting’ offer for the 2023/24 GP contract

Revealed: What was in NHS England’s ‘insulting’ offer for the 2023/24 GP contract

Exclusive: NHS England has proposed linking more funding to access measures and mandating practices to offer automated access to patient records by 31 July in its 2023/24 GP contract offer, Pulse can reveal.

Last week, the BMA’s GP Committee said it was considering industrial action following NHS England’s offer for the 2023/24 GP contract, calling it ‘insulting’ and a ‘slap in the face’ for GPs.

The GPC statement revealed that there was no increase in funding for general practice, despite the increase in cost of living.

Pulse can now reveal more details about the 2023/24 GP contract offer, which included:

  • £305m in the investment and impact fund (IIF) – the incentive fund for PCNs – including:
    • £246m for a capacity and support indicator, which involves things like patient experience and patients being seen with two weeks or less;
    • £59m for clinical indicators, such as cancer and flu;
  • An access marker added to the QOF, plus the inclusion of the cholesterol-lowering injection, Inclisiran;
  • Forced prospective access to records for all patients from no later than 31 July 2023;
  • No uplift to childhood immunisations or global sum, and pushing forward with pay transparency.

The current contract was introduced in 2019, for a five-year term, but there have been negotiations for minor changes throughout the term.

However, the 2023/24 GP contract offer has been the most controversial, with GPC acting chair Dr Kieran Sharrock stating: ‘This year’s offer is a slap in the face of hardworking GPs and patients across the country… For many undecided GPs, this insulting offer will likely be the final straw in pushing them out the surgery door.’

He added that if the Government were to impose a contact, the GPC would consider ‘all options’ including industrial or collective action.

The GPC statement had revealed that there was no increased uplift beyond the 2.1% agreed as part of the five-year deal, despite the huge increases in inflation.

However, the other elements of the deal could prove to be just as controversial.

The emphasis on access in the IIF and QOF is the latest in the long-running push by NHS England and ministers to place the burden of increasing access on GPs.

A Pulse analysis this year revealed that practices who offer more face-to-face appointments on average have longer waiting times and less consultations with GPs, suggesting that the problems with access are systemic.

The increased funding in the IIF – which currently stands at £260m – also reflects an increased emphasis on funnelling funding through PCNs, despite growing opposition to networks.  

There has also been strong criticism from GPs about the childhood immunisations payment scheme, which sees practices especially in deprived areas missing out on funding based on a few families declining to have the vaccinations.

Automatic access to patients’ prospective patient records had originally been due to be switched on by the end of November, following delays related to concerns about patient safety. However, this was later delayed indefinitely with this latest contract offer being the first indication since around a new launch date of 31 July this year.

However, the main source of contention remains the lack of increased funding. Pulse reported today that NHS England has suggested that the Review Body for Doctors’ and Dentists’ Remuneration (DDRB) should recommend a 2.1% increase in salaried GP pay in 2023/24 to reflect the uplift in practice funding.  

The next steps will be further negotiation between NHS England and the GPC. However, if there is no agreement, GPC has indicated it will be willing to pursue industrial action.

NHS England said that negotiations are ongoing, and the BMA has declined to comment.



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

Truth Finder 6 February, 2023 3:01 pm

It is a slap in the face. GPs should be paid for the work they do and not an all or none game once one passes a certain percentage. In deprived areas people just do not care but has more demands to be fixed when their drugs and alcohol and smoking causes problems. Flu uptake is terrible as lots of competition.

Some" Bloke 6 February, 2023 6:21 pm

we need to think about some sort of collective action that does not set us on collision course with big proportion of the public and doesn’t significantly impact patient safety. something along the lines of collective refusal of doing crem forms, or insurance reports or driving medicals. I know these are sources of some income for practices, but striking does not achieve anyhting- you just have to do all the work at later date. But collective action like that, with no end date- until disagreements resolved- could work if we are all prepared to hold the line for as long as it takes.

Bonglim Bong 7 February, 2023 2:35 pm

Some Bloke has it correct.

Collective action – picking actions which are expensive but neither contractual or dangerous would be a good place to start. And ideally picking actions which do not have a lot of funding attached.

Your suggestions of crem forms or insurance reports are private sector work. They don’t really harm the government at all (DVLA does).

But – refusing to use any referral forms and all referrals by letter might work.
Or lots of tools with prescribing:
– ending participation in work to keep down Px costs.
– starting to prescribe medication generically – even when the brand is cheaper.
– or step up to prescribe medication as an expensive brand, even when the generic is cheaper.
– and finally ignoring prescribing restrictions which are put in place to save money – so open season for pain killers, emollients, sun cream and so on. And a willingness (if safe and clinically happy to do so) to precribe drugs which are restricted through cost (expensive ED drugs, weight loss drugs and so on).

Alternatively I’ve heard there is a 2 for 1 deal on stickers at the moment.

Nobbies Piles 8 February, 2023 5:26 am

Refuse sick notes, pip requests, job centre plus forms.

James Weems 8 February, 2023 9:07 pm

Refer every patient to secondary care for a week

Nicholas Sharvill 4 March, 2023 11:42 am

Can someone share with me why there is such a push for Incliseran as currently no evidence it save lives or prevents cvd though it does reduce cholesterol. Bizarre that it is in the proposed contract when so much else in terms of specifics is not