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The global sum smoke and mirrors

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The Welsh Government recently announced that the global sum was to be cut by £2.88 per patient to pay for the state-backed indemnity scheme. It was understandably met with fury from GPs, who even talked about potential industrial action. The BMA is currently in talks with ministers about this.

But is the situation that much different in England? Or is it just that the BMA and NHS England have done a much better job of selling the new contract?

As we revealed today, only 9p of that 92p uplift is what we could describe as ‘new’ funding. The rest of it is funding taken away from practices who were relying on MPIG and seniority payments. We don’t have the figures yet, but it’s unlikely those practices’ core income will be increasing.

Is it just that the BMA and NHS England have done a much better job of selling the new contract?

That 9p is doing a lot of work. According to contract documents, it is for ‘inflation and other changes’. Let’s have a look at those ‘other changes’. It includes: £20m put in to cover the costs of dealing with subject access requests’; £30m to cover the work required to provide 100% of patients with extended access – up from the current 70% of the population required – and providing appointment slots for direct NHS 111 booking; and compensation for the ongoing problems with Capita.

This sounds like a lot more work than 9p per patient.

To reiterate, this is not to say the deal is a bad one. The payment of indemnity costs is a massive lift for practices, and we know that this year’s poor uplift is a one-off. And we know there is a lot of money going to networks – though this brings a whole raft of other issues into play.

What this ultimately means, however is that this is not the no-strings-attached, corker of a deal it was originally sold as.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at