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GPC chair urges GP practices to ignore NHS England on locum ‘maximum rate’



Exclusive GPC chair Dr Chaand Nagpaul has urged GP practices and locums to continue setting their own rates without regard for the maximum rate that is to be set by NHS England.

Speaking about the 2016/17 GP contract at the Pulse Live conference in London today, Dr Nagpaul said there was no contractual duty on GPs to change their behaviour in light of the rate, on which there was ‘no detail’ as yet.

He said NHS England does have the power to change the e-declaration form to force practices to report when they pay more than the indicative rate, but said it was not a contractual ‘cap’.

He told delegates: ’I think we just need to be sometimes strong enough just to carry on as we are. I am going to carry on paying my locums what I negotiate with them and they will carry on charging. And if I pay more than an indicative rate I will expose that as a fact that we are under-resourced to be paying for the expenses that we need to run our practices.

’That is the stance I think we need to take, to just challenge it head-on, and not be affected by anything that is not contractual.’

He urged GPs ‘together, as practices and as locums’ to ‘carry on doing what we know to be right’ and also not to ’give it credence by calling it a cap, because it isn’t’.

Dr Nagpaul was also defiant against plans for GPs to provide routine seven-day appointments to all patients.

He said it was ’ridiculous’ of the Government to expect to be able to pay ‘less than the rest of the developed world’ for healthcare and ‘offer something that no other part of the world offers’.

He said: ‘Not only is it ludicrous, it is immoral, because if we don’t have enough money to run our health service what we must do is use it for people who most need it… Paying GPs to not be there for the most needy and instead be there superfluously is just wrong and that is why we must challenge it. This is something we all should challenge collectively.’

He further warned GPs from being tempted by the new ‘voluntary’ GP contract being developed for practices with 30,000 patients or more that deliver on the Government’s seven-day commitment in a multispecialty community partnership (MCP) model, urging them instead to stick with the ’safety’ of the national GMS contract.

De Nagpaul said the GPC was watching the developments very carefully because ’what we must do is make sure practices don’t unwittingly get themselves into difficulties through short-term attractions’.

The GPC chair added: ’We also believe that the national [GMS] contract is entirely compatible with these MCP arrangements.’

What is the locum maximum rate?

After a cap on spending on locum agency doctors and nurses was rolled out to hospitals in England earlier this year, GP practices will be given an ‘indicative maximum rate’ for locums, which will see them reporting any breaches to NHS England once a national rate is determined.

The scheme – which is to be introduced by NHS England against the wishes of GP leaders – will mean that GP practices will have to report their locum spend for the first time to the NHS. It is unclear what this information will be used for and when it will be introduced, and there is no indication as to what the indicative rate will be.

Although the measure is part of the 2016/17 GP contract deal, the GPC did not agreee to it and NHS England has not detailed what will happen to practices breaching this maximum rate.