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GPC ‘looking into’ including payment by activity in contract negotiations

Exclusive The GPC has said that it is looking in to moving away from GP practices being paid according to capitation in the run up to contract negotiations for 2016/17.

Chair Dr Chaand Nagpaul told Pulse that the GPC were looking into the motion from the LMCs Conference that said the current payment system was ‘not fit for purpose’, and should be replaced by a ‘payment by activity’ contract.

However, he also warned about problems with such an approach, echoing the GPC’s opposition to the motion at the LMCs Conference.

Pulse can also reveal that changes to the Carr Hill formula – which determines how much each practice receives from the global sum, taking into account factors such as patient demographic – will not be made for the 2016/17 contract, despite previous suggestions they will be introduced next year.

Dr Nagpaul said that contract negotiations have been delayed this year, because NHS England has yet to finalise its mandate to NHS Employers, who negotiate on their behalf.

However, he added that GPC’s preparations for the negotiations have included discussions around payment by activity.

Dr Nagpaul said: ‘This motion has not been forgotten and it is part of something we are looking at now. What I said at the LMCs conference is that this is a very complex area and we have to be mindful also of the fact that the payment mechanism in secondary care is actually moving away from payment by result into other arrangements including capitation budgets.’

Changes to the Carr Hill formula had been mooted earlier this year, with NHS England and GPC involved in a review, which is being led by Tower Hamlets GPs, who told Pulse they expected changes to be announced in autumn.

But GP leaders have said that there will be no changes to the Carr Hill GP funding formula, which have been under consideration since 2007.

GPC deputy chair Dr Richard Vautrey told Pulse that the review group, which includes BMA representation, would report in time for the 2017/18 contract negotiations at the earliest.

He said: ‘We don’t expect the work to be done quickly. This is a big and complex project and if it is to be done properly then it needs the necessary time to do it.’

The advice comes as the GPC and the Government have not even begun negotiating the 2016/17 GP contract yet, because NHS England has yet to finalise its mandate to NHS Employers. Although commonly begun earlier in the summer, discussions are now expected to start later this month.

An NHS England spokesperson said: ‘NHS England is committed to reviewing the Carr-Hill formula which underpins the capitation payments made to GP practices under the General Medical Services (GMS) contract.  This commitment was confirmed in the wider New Deal for General Practice, which was set out in our Five Year Forward View.

‘We are working with the BMA’s General Practitioners Committee, NHS Employers, the Department of Health and academic partners on the review to develop a formula that better reflects the factors that drive workload, such as age or deprivation.  This work continues and we will communicate further in due course.’

Meanwhile it was revealed last week that GPs will be lured away from the national GP contract to join NHS England’s new models of care via simpler and more attractive conditions potentially undermining the contract and the GPC’s negotiating position.