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Wales to overhaul GP contract as funding is boosted by 2.7%

The Welsh Government and GPC are starting negotiations that will see an overhaul of the GMS contract, following the announcement that Welsh GPs will see a funding increase of 2.7% from April.

Under the new contract agreement announced by health secretary Vaughn Gething at the Welsh LMCs Conference on Saturday, which will add £27m to the budget for GMS practices next year,  GPs will also take on a new DES designed to reduce variations in care for care home residents. 

But at the same conference, Wales GPC chair Dr Charlotte Jones said that the ‘writing has been on the wall for the GMS contract for some time’ and the BMA is in negotiations with the Welsh Government to overhaul the contract entirely, reviewing areas such as QOF, indemnity, GP access, social prescribing and reducing non-core activity.

The changes to the current contract announced on Saturday are designed to give GPs a 1% pay increase, a 1.4% uplift to ‘general’ practice expenses, contributions to indemnity and pensions costs, and increases in maternity, parental leave and sickness absence. 

The contract will also include new enhanced services, including:

  • A care home DES ‘to all 22,700 nursing and residential care home residents in Wales aimed at reducing variations in care.;
  • A Warfarin management service ‘offered by all GPs in Wales’ to ensure checks are carried out within the practice alongside discussions of other health issues and prescribing changes;
  • A Diabetes LES to provide a more ‘comprehensive package of care’ to Welsh patients;
  • And additional resource for workload from completing phlebotomy requests from other providers.

A decision on whether to extend the relaxation of QOF for 2017/18 will also be agreed by 31 March as will a revised cluster network domain.

GPC Wales chair Dr Charlotte Jones said the committee ‘welcomes the collaborative approach taken by Welsh Government to help address the challenges facing GPs in Wales.’

Talking to Pulse, Dr Jones said in reviewing the contract everything was up for discussion and it was too early to say how different it would be from what is in place now.

‘We are looking at models of care in the UK and around the world,’ she said.

In her speech to the conference, Dr Jones welcomed the support for general practice from the Welsh government and the commitment from Mr Gething to independent contractor status.

GPs are ‘demoralised and experiencing overwhelming and relenting workload pressures’, Dr Jones told delegates.

Combined with ongoing recruitment problems, GPs have little time to ‘raise their heads during the working day’ to consider what can be done through practices and clusters to transform general practice, she said.

But she said it was not too late to solve the problems facing the profession and they were starting to see progress in being heard on key issues.

Dr Jones pointed to success with addressing last man standing liabilities, putting in place a workforce strategy plan with incentives to attract new GPs and reducing bureaucracy.

Outlining 10-point plans for workforce, workload and resources, she said momentum and pressure was needed so GPs ‘can visibly see change happening on the ground’.

‘Let’s make 2017 the year where change really does happen,’ she said.

Vaughan Gething said: ‘I’m confident that this approach of working in partnership is the right one, as we continue to transform primary care in Wales. It provides a strong platform for GPs to continue to provide high quality, sustainable, healthcare’.

In 2015 the Welsh GPC agreed a two-year contract to give practices ‘stability’, and the 17/18 copntract is in addition to already announced funding for training other health professionals to support GPs and develop ‘GP clusters’.“