What could a ‘new deal’ for GPs look like?

Some well-connected sources tell us that the promised ‘new deal’ for general practice is proving a real headache within the Department of Health.

The health secretary’s Rooseveltian moment occurred on BBC Radio 4 last month where he promised he would set out new arrangements for GPs that would address the spiralling demands on the service.

‘We need to look at the terms and conditions of general practice; we need to look at why GPs have so much burnout’, he said. But his promise has left civil servants scratching their heads.

After this build up, Mr Hunt needs to make the profession a big offer, but in a time of financial austerity he has very little wiggle room. The politics are also difficult, with an ever-watchful Daily Mail ready to pounce on anything that looks like a handout to GPs.

Apart from some dark mutterings about locum terms and conditions, there is very little sign of what he will come up with. But perhaps he is not speaking with the right people, because I could give him a whole list.

Focussing on the immediate, relief from the box-ticking and petty paper-shifting of DESs, the QOF and CQC inspections and, perhaps, even lengthening the frequency of revalidation would prove welcome.

Stabilising practice income would also help – putting a halt to all PMS reviews, the MPIG withdrawal and the pointless shifting of the contractual goal posts every single year.

But the biggest problem at the moment is the GP workforce. We must forget about the mythical 5,000 more GPs, they will come too late (if at all) to do any good. Professor Martin Roland’s review of the workforce for Health Education England will be published soon and I would not be surprised if he recommends more pharmacists in practices, health trainers and physician associates to help practices cope. Potentially a salve that could be prioritised immediately.

And the last thing we come to is premises. NHS England chief executive Simon Stevens’ vision of GP practices expanding to secondary care, community and social care services makes sense, but only if there is something better than a musty back room to house them.

The £250m injection into practice premises projects this year was a good start, but more is needed. Managers need to work more closely to give practices the ability to upgrade and expand, and then community and social services can be wrapped around them to better support patients outside of hospital.

And this is the clever bit. None of this looks like a payment to GPs, but it could make all the difference. But what do I know, I’m just a journalist.

Nigel Praities is editor of Pulse