BMA reveals GP contract asks including replacing ARRS with practice-level scheme

The BMA’s GP committee for England has revealed its asks for the next GP contract, as the overhauled contract consultation process is currently underway.

The GPC has published three papers outlining its proposals presented to the Government in a meeting last week, including:

• Replacing ARRS with a ‘practice level funding scheme’ to ‘support practices to hire more GPs’
• Increasing the Global Sum payment per weighted patient by £50 extra per patient per year, from £123.34 to £173.34, in 2026/27
• Introducing a clause to GMS/PMS/APMS contracts that requires practices to ‘sign declaration letters’ confirming they have passed on the annual uplift to their employed GPs following DDRB recommendations ‘or risk a potential enquiry’; and for the uplifts to be ‘fully funded and ringfenced’ and to specifically include all employer on costs on top of the percentage pay award offered
• Introducing a ‘Partnership Premium Scheme for GPs’ in England, designed to incentivise GPs to ‘take up and remain’ in partnership roles within practices
• Replacing the existing ‘patchwork of regional LESs’ in relation to safeguarding with a ‘comprehensive nationally agreed DES’

As exclusively revealed by Pulse, instead of GP contract negotiations with the BMA’s GP committee, the Government is currently ‘consulting’ it alongside a wider group of stakeholders, including the RCGP and patient groups.

In a message to GPs on Friday, GPC England deputy chair Dr Samira Anane said: ‘We submitted several high-level papers and counter proposals from our perspective under a series of themes, and in a departure from usual practice, we have published our contract proposals.

‘These proposals build on our historical contract asks around the need to restore resourcing levels for general practice and the GP unemployment crisis, and complement several key publications developed to support the profession and practices, working towards hope, safety and stability.’

The new practice-level funding scheme would replace the existing PCN GP element of the ARRS, allowing practices to ‘independently recruit and retain GPs’ to provide direct patient care at a practice level, the GPC said.

The documents added: ‘The ultimate goal is to improve access to general practice, strengthen job stability for GPs, and enhance continuity of care for patients.

‘The scheme would support NHS practices to hire and retain GPs more easily, with funding allocated directly to each practice based on practice size and recruitment issues.’

Funding for the scheme could be via a reimbursement mechanism providing a ‘clear, transparent use’ of those funds that provides direct benefits to patients and practices, the documents said.

‘Funding could be drawn from other areas of the contract, such as repatriating all or part of the CAIP, or £1.7 billion of annual ARRS funding for use at practice level, re-orientating that money to directly support the provision of general practice services to the public,’ the GPC added.

It argued for practice-level funding allocation so that funding is distributed ‘directly’ to practices and for ’employment support grants’ so that each practice could receive funding based on factors such as patient numbers, GP-to-patient ratios, and regional demand, which would be ‘ringfenced exclusively for GP employment’.

On the proposed DDRB declaration for practices (see box), the GPC said that this would ‘promote good practice, compliance with the salaried GP model contract’ and fairness in pay across general practice.

The documents also point out that the the increased investment of £50 per patient per annum would be used to ‘explicitly grow an additional workforce’, with a ‘focus’ beginning with practices ‘in socially deprived communities’.

And the Partnership Premium Scheme would be open to qualified GPs who join a partnership or remain in a partnership role within NHS GP practices in England, allowing them to receive an annual payment of £1,150 per clinical session (for up to a maximum of 8 sessions per week), and increasing to £1,316 per session for those with over 16 years’ experience (up to a maximum of 8 sessions per week).