Five-year GP contract made things ‘tighter’ for practices, says NHSE

Exclusive The five-year GP contract framework has contributed to making things ‘tighter’ for practices, NHS England’s director of primary care has said.

In an exclusive interview with Pulse, national director of primary and community care services Dr Amanda Doyle said that changes in inflation, which could not have been predicted when the contract framework was agreed in 2019, have contributed to putting practices in difficult financial positions.

The contract agreement in 2019/20 stipulated that there would be funding increases of just over 2% every year until 2023/24.

The former chair of the BMA GP Committee, Dr Vautrey, who negotiated the deal, said earlier this year at Pulse Live that the rest of the NHS ‘envied’ this deal.

However, inflation is currently at 6.8%, and hit as high as 11% in 2022, which has left practices struggling with the more recent funding uplifts.

As a result, earlier this year, the BMA’s GP Committee England was been given a mandate to explore GP industrial action in response to the ‘derisory’ agreed funding uplift.

In the interview with Pulse, Dr Doyle acknowledged that the funding uplift did make things ‘tighter’ for practices.

She said: ‘I appreciate that changes in inflation, which hadn’t been predicted when the five year contract framework was agreed, have made things tighter for practices, I absolutely accept that.

‘But nevertheless, the total quantity of investment in primary care has increased very significantly over the last five years.

‘And we’re increasing other services in the community, things like virtual wards, NHS at home services, urgent community response services, acute respiratory hubs, a whole range of services that are in the community in which we have significantly increased investment. And we’re committed to continuing to do that.’

Earlier this month, Pulse also exclusively revealed that NHS England is ‘not in a position’ to negotiate to a new five-year GP contract due to a lack of a funding commitment, with the 2024/25 contract set to be a ‘stepping stone’.

Dr Doyle told ‘it is almost certain’ that they will not be negotiating a new five-year contract starting next year, because NHS England only has a one-year funding settlement for 2024/25.

The current contract runs out in 2024, and it had been thought that the 2024/25 would herald a seismic change in general practice in England, similar to the 2004 contract that removed out-of-hours obligations from practices.

There have been radical suggestions from both sides of the negotiations, including moving to payment by activity, scrapping QOF and introducing contractual workload limits.

But in the exclusive interview with Pulse Dr Doyle suggested that the next contract was going to be a one-year deal.

However, she also said that there is ‘an opportunity for longer-term reform’ of the GP contract from 2025/26, including reforms around QOF.

And she confirmed that there was ‘absolutely no risk to PCNs’ and that PCNs should feel confident to continue recruiting staff under the additional roles reimbursement scheme (ARRS) without worries funding could be withdrawn.