Further expression to elements of the 2018 Scottish GMS Contract detailed below have now been agreed.
What's new in the 2018 contract
- A new funding formula that better reflects GP workload with additional investment of £23m.
- 63% of practices gained additional resources from contract changes, as well as increases from annual uplifts that all practices have received.
- A practice income guarantee ensures practice income stability.
- A minimum earnings expectation ensures that GPs in Scotland earn at least £80,430 (whole-time equivalent including employers’ superannuation).
- GP practices will provide fewer services.
- New community services will be developed and be the responsibility of NHS boards. Funding for replaced services will remain with practices.
- There will be a wider range of professionals available - employed by NHS boards and attached to practices.
- Priority services include pharmacotherapy support, community treatment and care, and vaccinations transfer.
- Changes will happen in a planned transition over three years when it is safe, appropriate and improves patient care.
- There will be national and local oversight involving SGPC and local medical committees.
- Risks associated with contracting will be significantly reduced.
- GP owned premises: new interest-free sustainability loans will be made available, supported by £50 million in the scheme’s first two years.
- GP leased premises: there will be a planned programme to transfer leases from practices to NHS boards.
- A new data sharing agreement, reducing risk to GP contractors.
- A focus on the GP as the expert medical generalist and senior clinical decision maker. In this role the GP will focus on three main areas: undifferentiated presentations; complex care in the community; and whole system quality improvement and clinical leadership.
- GPs will lead an extended team of primary care professionals.
- GPs will have more time to spend with the people who need them most.
- The move toward peer-led quality, professionalism and transparency; and away from micromanagement will continue.
- GPs will be more involved in influencing the wider system to improve local population health.
- GP clusters will have a clear role in quality planning, quality improvement and quality assurance.
- GPs will have contractual provision for regular protected time for learning and development. Initially practices will have resources to support one session per month.
- GP census will properly inform GP workforce planning.
- At least 800 GPs over ten years to fill vacancies.
- The main way to improve recruitment and retention is to improve the GP contract, in the ways detailed above.
Memorandum of understanding
The MOU establishes a national agreement between the BMA, Scottish Government, integration authorities and health boards to implement the 2018 Scottish GP contract. It outlines the funding that will be made available.
The MOU sets out:
- agreed principles of service redesign
- ring-fenced resources to enable the change to happen
- new national and local oversight arrangements
- agreed priorities
- how GP subcommittees and local medical committees will have expanded roles in developing and agreeing local HSCP plans to implement the contract.
A further MOU2 was established and agreed between the parties to implement the 2018 Scottish GP contract to cover the period 2021-2023.
The central purpose of the MOU remains the implementation of the 2018 contract and specifically the transfer of the provision of ‘MOU services’ from general practice to HSCP/Health Boards.
The MOU reflects our previous agreements with Scottish Government to:
- Establish in regulations that integrated joint boards/health boards are responsible for providing vaccination, pharmacotherapy and community treatment and care services to patients and GP practices.
- That SG and SGPC will negotiate transitionary service arrangements for practices that support IJBs/HBs with the routine delivery of MOU services after 1 April 2022. We have committed to developing the principles for how transitionary services and payment arrangements will work by the end of summer 2021.
Premises code of practice
The Scottish Government and the BMA Scottish GP committee (SGPC) have agreed a national code of practice for GP premises. It sets out how the Scottish Government will support a shift, over 25 years, to a new model in which GPs will no longer be expected to provide their own premises.
All GP contractors who own their premises will have the option of taking out an interest free sustainability loan, up to the value of 20% of the existing-use value of the property.
For GPs who lease their premises, there will be a planned transition to the health boards leasing these premises.
NHS boards will gradually take on the responsibility from GP contractors for negotiating and entering into leases with private landlords and the subsequent obligations for maintaining the premises.
Statement of financial entitlements
The SFE establishes how practices are paid under the general medical services contract.
Negotiations for phase two of the GMS contract
Phase one was presented, voted on and accepted by the profession, and SGPC and Scottish Government have begun negotiations on phase two. Any proposed phase two changes will be presented to doctors once negotiated, and subject to a second contract poll.
Some broad intentions for phase two have been agreed.
Phase two of the contract, if implemented, will further reduce the risks of partnership, by introducing protected GP incomes and direct reimbursement of practice expenses. This will see a similar income scale to consultants introduced for GPs, with pay progression to recognise seniority.