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Next contract needs cap on patients per GP, says GPC chair

Next contract needs cap on patients per GP, says GPC chair

A ‘recommended’ number of registered patients per GP should be included in the next contract, the BMA’s GP Committee chair for England has said.

Dr Katie Bramall-Stainer said that ‘objective metrics’ are ‘desperately needed’ as part of a new ‘substantive’ GP contract, including a ‘maximum number’ of registered patients taking into account GP ratio and working hours.

The five-year contract deal ran out this year, and with the 2024/25 imposed contract being a ‘stepping stone’, the GPC will be discussing a new contract with NHS England and the Government for 2025/26.

Dr Bramall-Stainer told Pulse that a cap on patient numbers ‘has been on her mind’ for weeks now, while ‘drafting’ the GPC manifesto ahead of potential industrial action later this year.

According to an ‘approximate timeline’ for potential GP industrial action set out by the BMA, the GPC is expected to publish a ‘vision document’ at its meeting on Thursday (16 May).

In a post on X, Dr Bramall-Stainer said that the next Government ‘whoever they may be’ will need to provide ‘safety’, ‘stability’ and ‘hope’ for general practice, including supporting the GPC call for a new GP contract.

The call followed a BMA referendum on this year’s imposed contract, which found that 99% of GPs did not agree with the imposition.

Dr Bramall-Stainer told Pulse that the recommended maximum number of registered patients is ‘not a metric for BMA to determine’ but needs a think tank to do ‘some decent research’ on consultation rates and morbidity to help support it.

She added: ‘We need to be bold to safeguard the nation and take a preventative agenda.

‘UK general practice was always the diamond in the NHS crown. It’s taken years to break, it’ll need years to rebuild but we have no choice.

‘If you want to keep a health service free at point of use – and we can’t afford not to – we need to protect and resource the generalist gatekeeper. Break the gatekeeper, you break the NHS.’

She also said that general practice needs:

  • ‘a target to aim for an evidence-based percentage of NHS resource ringfenced for a safe and stable general practice contract – start with aspirations, but move towards it through a parliamentary session’
  • ‘work backwards from what the NHS wants general practice to deliver. Cost it up and commit it: £/patient. Why? Because it will a) work & b) be cheaper than anywhere else in the NHS’

‘We need to protect our practices and protect our patients,’ she added.

The BMA will soon be providing ‘formal advice’ on unresourced work done by GP practices, which is likely to form the basis of future industrial action.

It is also planning ‘roadshows’ across the 10 England reasons next month, to discuss potential industrial action and to ‘consider what happens next’.

As reported by Pulse earlier this year, the GPCE seems to be mainly looking at options for collective action that would affect GP interface with other NHS services as well as workload, rather than practices ‘shutting their doors’.

Last month, Dr Bramall-Stainer wrote to NHS England to state that they are ‘now in dispute’ based on this year’s imposed GMS contract.

It also alerted all 42 ICBs of ‘significant risks’ which may arise from potential industrial action by GPs later this year.



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

David Banner 14 May, 2024 1:45 pm

Governments can’t guarantee patients will be registered with a GP whilst imposing a maximum number of patients on struggling practices, so this will never happen (as anyone who has tried to close their lists will testify).
But there is a window of opportunity during the “employment crisis” for HMG to encourage entrepreneurial young GPs to start up new GMS practices in underdoctored areas, rather than continuing with the false economy smash and grab of APMS grifters.

Scottish GP 14 May, 2024 2:42 pm

Grifters indeed. APMS opportunists hoovering up failing practices. Providing atrocious levels of service to usually disadvantaged vulnerable patients in the name of progress. This egregious situation encouraged by Health Boards in Scotland as they do not want the responsibility of running practices. A scant review of reviews of such practices says it all. Time for some proper investigative journalism.

Not on your Nelly 14 May, 2024 3:31 pm

8 to 7pm. The contract is 8 to 6.30!

Anony Mouse 14 May, 2024 5:43 pm

They’ll never agree to a maximum number of patients per GP because they know that there simply aren’t enough FTE to make this a reality. The same as they will never specify a safe number of contacts per day as they know that this wouldn’t come anywhere remotely close to meeting demand. The numbers don’t work and they know it!

Centreground Centreground 14 May, 2024 5:50 pm

It is not simply APMS practices hoovering up failing practices, it is opportunistic failing PCNs with business single minded as opposed to patient minded Clinical Directors with increasing ICB contacts formed partially via PCN roles also undertaking precisely the same tactic but utilising NHS taxpayer funding and hence falling under the radar!

Post Doc 15 May, 2024 7:36 am

Is KBS is implying the “new” contract will impose 0800-1900?