BMA demands ‘immediate pause’ of contractual GP telephony requirements

The BMA’s GP committee has asked NHS England to immediately pause its cloud-based telephony project, following concerns around ‘skyrocketing’ costs for GP practices.

This year’s GP contract imposition stipulated that GP practices must procure cloud-based telephony once their current contracts expire, and £240m of funding was announced as part of the recovery plan, with a focus on replacing old analogue phone systems.

But last month GP leaders warned that the new cloud-based telephony systems will cost ‘cash-strapped’ GP practices up to £10,000 extra per year.

The BMA raised concerns over the past year about increased costs to practices moving to cloud-based telephony, including during negotiations for the 2023/24 GP contract.

Now GPC England’s deputy chair Dr David Wrigley has written to NHS England asking the commissioner for an ‘immediate pause’ of the project ‘to take stock of where we are and how we proceed from here’.

In his letter to NHSE’s national director for primary care Dr Amanda Doyle, seen by Pulse, Dr Wrigley said that with the requirement for GPs to procure exclusively from providers on the Better Purchasing Framework (BPF), many practices ‘have seen costs skyrocket’, for services that ‘they currently pay reasonable sums for’.

He said: ‘We have seen invoices from current telephony providers as well as the payments required for future contracts with different companies and they show exponential increases – some by an incredible 470%.

‘Though figures vary between practices, some members have seen increases of as much as £3,200 per year – from £800 to £4,000 – with all these costs expected to be covered by the practice and no additional funding provided to cover them.

‘At a time of significant pressure on GP finances this is the last thing GP partners wish to see, particularly on a contractual issue mandated by the 2023/24 imposition.’

Dr Wrigley also said that during last year’s contract negotiations concerns were raised about increased costs to practices moving from current suppliers to CBT suppliers on NHSE’s BPF, but that the GPC was advised ‘numerous times’ that costs would not increase.

‘Yet this could not be further from the truth for colleagues across the country,’ he added.

‘ICBs have been given very little help or guidance to support practices and this has led to huge frustration from colleagues trying to engage with the system.’

He said that his own practice was given just 48 hours’ notice to review a complex 149-page contract with ‘many unanswered questions remaining’ and that he did not feel able to sign the contract ‘given those cost and time pressures’.

The letter also asked for an urgent meeting to discuss ‘how best to resolve this serious situation’.

Dr Wrigley added: ‘Some [practices] are seeing rises of 300% to their current telephone system costs. We cannot expect GP practices across the country to cover these significant additional costs without much needed support to help them manage the transition.

​​’Ultimately, without more funding in the practice infrastructure, this new system will be a further blow to GP surgeries already struggling to cope.

‘We need an immediate pause on this new programme of work and then work to ensure this new system is in the best possible place, so we don’t create additional problems for GP surgeries across the country.’

Pulse has approached NHS England for comment.

Earlier this month, NHS England said more than eight in 10 GP practices now ‘have digital telephony in place’.

However, NHS England’s primary care director Dr Amanda Doyle told Pulse that having a new telephone system ‘is not the answer on its own’, and that it must be combined with other digital tools to improve patient experience.