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A united, engaged profession can create opportunities for genuine, positive change – and in the new GP contract for 2020/21 that is exactly what we have won.
It has been hard-fought, and much-needed, progress. After the debacle of NHS England’s draft service specifications on Primary Care Networks (PCNs), rushed out before Christmas, concerns about increased workload, detail of the specifications and micro-management of GPs and practices were rife. And the opportunity of tangible investment and integration which accompanied the original iteration of the PCN project were in danger of being lost.
But the profession, united and engaged, responded to NHS England in unison with strong representation from the BMA’s GP committee backed up by 4,000 responses to the official consultation.
We told NHS England that GPs and practices must be trusted to deliver good quality care for patients, without further micro-management, and that the underfunding of vital primary care services cannot continue. We said practices must have more control over what they do, how they utilise new staff and that there must be no extra burden on the shoulders of GPs as a result of this contract and the continued development of PCNs. And we said practices were struggling to fund the additional workforce required as part of PCNs – and that 100 per cent funding from NHS England was required.
After successful negotiations all of these things have become a reality and, after so many years of under-funding and increased demand, we can look forward to a brighter future for our profession. This is a GP contract which will provide more funding and support an increased workforce, not only for the next four years but with an explicit commitment to long-term investment.
In the past we have seen funding promises which appear to be little more than smoke and mirrors, but we will not stand for false promises or kicking the can down the road. As part of this contract it has been agreed that GPs will be able to monitor the delivery of promised money, with CCGs ordered to provide LMCs with annual updates detailing progress.
This contract also provides recognition of the importance of the GP provider model, with £20,000 available to all new partners and £3,000 for the new partner for training. It also includes support for childcare costs to help GPs returning to practice with children under 11 and a locum support scheme including CPD offered.
The progress made through these negotiations could prove to be game-changing for the profession. Through this contract we can reduce financial burden on practices, we can increase the workforce delivering primary care and we can organise services to better suit our colleagues and our patients. And by doing all this we can start to reduce the current GP workload burden.
However, there is still more work to be done.
As the specifications for PCNs continue to be discussed (most recently at the BMA’s PCN 2020 conference) and the plans rollout further it is crucial the spirit and tone of the agreement is kept in mind. General practitioners must not face increased workload or micro-management as a result of any changes – this is an opportunity for genuine, positive change, and we will not allow that to be lost.
It is also vital that the investment into, and focus on, primary care does not end here. We still have practices across the country unfit for purpose – too small to cater for the demands of increased workforce, GP trainees spending more time in surgeries, or new ways of working. And so many GP practices are forced to make the best with out of date computer software, sluggish internet service and front-of-house systems that do not help to decrease unnecessary attendances or manage the needs of patients. Investment into infrastructure, technology and equipment is vital – and we expect the government to recognise this in the upcoming budget and subsequent spending reviews.
Read more details on the new contract
Richard Vautrey is chair of the BMA GP committee
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