More than half of GPs want to see staff costs ringfenced in new GMS contract

Exclusive More than half of GPs want to see staff costs ringfenced in a new wholesale GMS contract, the results of a new Pulse survey have revealed.

A poll of 667 English GPs showed that 54% ‘strongly agreed’ that staff costs should be ringfenced and funded separately to the global sum as part of a new contract for general practice.

The BMA is aiming to agree a totally new contract for the profession by the end of next year, which could include a ‘full reimbursement mechanism’ for salaried GPs, as per the old Red Book GMS contract.

The Pulse survey also found that 76% of respondents either strongly agreed or somewhat agreed that the Carr-Hill formula needs a major overhaul as part of the new contract.

It also found that:

• 29% strongly agreed that PCNs should be scrapped
• 48% strongly disagreed with a move to a salaried GP model
• 26% either strongly or somewhat agreed that the responsibility for urgent and on-the-day appointments should be taken away from general practice  
• 25% strongly agreed that QOF should be scrapped (see box below for full results)

On staffing costs, one GP said: ‘If we could afford more staff then we could do more urgent care work. It’s better for continuity to have primary care work with the home GP surgery.’

A GP from Northamptonshire told Pulse: ‘My personal view is that Carr-Hill needs to be reviewed since it does not reflect the number of consultations that are required for current patient needs.

‘I am still supportive of a contract that has an element of capitation funding since this supports continuity. We have some patients that are having up to 150 appointments a year.

‘However, my concerns about a new formula to replace Carr-Hill are that without additional total funding we will just create different winners and losers with regard to practice funding, even if it is “fairer”.’

Another GP said: ‘The partnership model works, as evidenced by primary care being the only part of the NHS not being run in deficit.’

GPC chair Dr Katie Bramall-Stainer said the results showed that GPs ‘clearly agree’ with the BMA that the current contract is not fit for purpose, and their feedback is ‘critically important’ for the negotiations.

She said that the BMA has already set out its demand for practice-level direct reimbursement for staff, which is expected to be part of the negotiations for the new contract.

She added: ‘A minimum general practice investment standard and more practice-level direct reimbursements for staff are already in our Patients First vision paper.

‘If working within a capitated contract, the funding formula will need to be reworked to better address social equity across our patient communities and support better continuity of care.’

Doctors’ Association UK GP spokesperson Dr Steve Taylor said: ‘The results of this survey show where the majority of GPs are in their thinking. The answers are here for Government, Department of Health and Social Care and NHS England.

‘They would be foolish to ignore this, because ultimately this will provide better patient access and care.

‘The top-down approach is not working and it’s vital that they listen to GPs who know how to make things better.’

Pulse has contacted the Department of Health and Social Care and NHS England for comment.

The BMA has recently revealed that it will survey GPs this summer on their priorities for the new contract.

The union’s agreement to the current 2025/26 contract was conditional on the Government’s commitment to negotiate a wholesale new GP contract within this Parliament. 

And in March, health secretary Wes Streeting provided his assurance to ‘secure a new substantive’ contract ‘without preconditions’ and ‘based on collaborative work’ with the profession. 

Pulse has looked at what the new contract could look like, including a possibility for the outcome of the negotiations to be ‘subject to approval’ from the profession ‘via one or more referenda’ of BMA members.