This week has seen the announcement of details of our contract deal with NHS Employers for 2018-19. The overall package delivers £256M of additional investment for the coming year, which is more than recent years and provides an interim uplift on pay and expenses while we await the outcome of the DDRB process, and help on indemnity costs.
The deal will be welcomed cautiously but is hardly likely to provoke celebration in the nation’s surgeries. General practice in England is in need of emergency resuscitation, and while this investment may be akin to intravenous access and two bags of colloid, the full skills of the crash team are still required.
The message has been delivered loud and clear that our sector requires significant investment simply to stabilise the situation and enable practices to meet the growing needs of our patients. Crucially it is important to recognise that this deal is not the whole story. It is not even half the story.
In addition to this new resource we have explained in detail to the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) why we need a resource bolus of RPI + 2%. We await their deliberations with interest, but there must be a realistic settlement to this year’s investment if the government is serious about stemming the flow of doctors deciding to leave general practice.
National declarations of support for the partnership model must be accompanied by real investment
In addition to the baseline deal and the possibility of a higher DDRB award there is now serious work being done on some of the big issues facing us. National declarations of support for the partnership model of general practice must be accompanied by real investment, genuinely new resources, and proper support. This has been heralded by the establishment of a full review of the partnership model and another to try and find solutions to the many problems relating to premises that must inform the scale of the challenge, but also the risks of failure.
The fourth major strand in the pursuit of a revived general practice sector must be the establishment of an indemnity system for all GPs and their staff which is equivalent to that provided to consultants and other secondary care doctors these last 28 years. Jeremy Hunt has announced the launch in April 2019 of a state-backed indemnity scheme and this is to be welcomed. Now it is for the Treasury to ensure the resources for this to function properly. This is a vital plank of any recovery plan and a major piece of work over which the GP Committee (GPC) continues to engage.
Increasingly, the resuscitation work necessary to ensure a vibrant general practice sector, and the survival of the NHS that is dependent upon it, takes place outside of the annual contract negotiations. This is not to downplay their importance, but to recognise that many of the hard yards are being achieved on other fields of play.
Dr Mark Sanford-Wood is deputy chair of the GPC
