Deadlines for implementing parts of the Scottish GP contract have been extended after it became apparent services would not be in place by April 2021 as originally planned.
A joint letter from the BMA and Scottish Government reconfirmed the commitment to investing £500m per year in primary care by 2021, including £250m in direct support of general practice.
But it set new timelines for the removal of several services from general practice to become the responsibility of multi-disciplinary teams employed by NHS boards.
Vaccinations still in the core GMS contract – including childhood immunisations and travel vaccinations – will be transferred to health boards by October 2021, six months after the original date, the letter said.
And where GPs are still needed to provide these services, there will be additional funding as part of a Transitory Service, the BMA’s Scottish GP Committee confirmed.
Other services due to move to health boards, including pharmacotherapy and community treatment and care will now have to be in place by 2022-23 – a year behind what was originally proposed when the new GP contract was introduced in 2018.
Urgent care and additional professional roles including mental health workers and physiotherapists have been given a two-year extension due to the need to clarify the ‘endpoint’ for those services, the joint letter said.
In some remote and rural communities where there may be no alternative to GPs providing these services, the Scottish Government and Scottish GPC will negotiate a separate arrangement including funding, it added.
GP leaders had warned one year into the new contract that implementation needed to speed up.
Speaking with Pulse, Scottish GPC chair Dr Andrew Buist said it was disappointing that the original plan to have all these services in place by 2021 was not going to happen.
‘We think the overall direction of travel is right and we need to keep the faith,’ he said. ‘This will get this programme back on track’.
But he stressed that they negotiated the dates because it could not ‘drag on forever’.
‘We have got ourselves some extra time. This is one final chance to get this right.’
There were several reasons behind the delay, he explained, including shortages of pharmacists and nurses, as well as logistical issues such as IT, management support, and room space as well as the Covid-19 pandemic, he added.
‘Like any negotiation there’s been a trade and we agreed six months, one year, two years depending on the service and in exchange we have hard-edged agreements that services will be written out of the contract.’
He said the Transitory Service agreements where practices would be funded when services were not available was not their ‘preferred option’ but it would be a lever for change as it would become increasingly punitive for health boards not to provide it.
He said the plans were partly about reducing GP workload but also about making care for patients better.
‘We have given up to two years for urgent care and mental health because the end points are not as clear as they should be so need to do a bit of work on that,’ he added.