General practice contract imposed as taskforce promised

Imposed last night by NHS England, practices are to get a small funding increase of 2.23% as part of this year’s contract.

The BMA is now set to run a ballot of GPs next month over whether to take protest action. The contract will require practices to “consider” continuity of care, while 32 QOF indicators will be suspended and their income protected.

The Government described the contract as a “stepping stone” towards fundamental reform, promising a taskforce later this year to consider the future of general practice. The contract allows for 2% pay increases for doctors, practice managers and other staff.

Dr Katie Bramall-Stainer, Chair of the BMA’s GP Committee for England, said: “The Government and NHS England have demonstrated that rather than being the stepping stone year to safety, stability and hope, 2024 will instead mean reduced patient access to GP services as well as likely closures of GP practices across the country.”

Continuity reduces demand for appointments

Good continuity of care in general practice could reduce consultations by about 5%, according to analysis published in ‘Management Science’.

Cambridge University researchers found that patients extended the gap between visits by 18% when they were confident that they would see their usual doctor. The findings come from analysing 10 million consultations in 381 practices over 11 years.

Researcher Professor Stefan Scholtes said: “The impact is substantial: it could be the equivalent of increasing the GP workforce by 5%, which would significantly benefit both patients and the NHS. Better health translates into less demand for future consultations. Prioritising continuity of care is crucial in enhancing productivity.”

Devolve primary care funding allocations, NHS managers say

Local health systems should be allowed to increase spending in primary care “proportionately”, according to NHS representatives.

The proposal would allow local health services to tackle the decline in spending on general practice and is contained in a list of priorities for the next Government, compiled by the NHS Confederation. The Confederation calls for a near doubling of capital funding for the NHS, an increase of £6.4 billion.

Chief Executive Matthew Taylor said: “There is no shortage of analysis and advice about what the NHS needs. This is why we have worked with health leaders across our membership to identify the five most critical priorities for the next government that will set the NHS on a path to recovery and sustainability.”

Same-day hubs planned for London

A second area of England has unveiled plans for “same-day hubs” to triage patients seeking practice appointments. NHS North West London says that senior GPs and a multidisciplinary team drawn from local services will staff each proposed hub. The hub, based on a primary care network, will be able to send patients to a practice with same-day appointments when their own practice has none available. The hubs are to be introduced on 1st April. Buckinghamshire, Oxfordshire and West Berkshire announced similar plans last week.

According to Londonwide Local Medical Committees, GPs have raised “significant” concerns about the speed of introduction: “A shift of this magnitude in the way of working would require a safe, effective model of care to meet patient need, and a change management process over time. It is clear from feedback we have received that there is immense concern regarding this model.”

Small increase in qualified GPs

The BMA claims that the number of fully qualified GPs is increasing far too slowly to meet demands.

NHS Digital has reported an increase of 649 GPs in the last year. The number falls to 248 when calculated as full-time equivalents. The total number of qualified GPs working in England was 37,177 at the end of January.

Dr David Wrigley, Deputy Chair of the BMA’s GP Committee for England, said: “We cannot get away from the fact that the number of fully qualified GPs in England is way below where it should be, and the rate of increase we see is far too slow to meet the current demand on general practice. If this trend continues, it’ll take until December 2026 just to get back to the number of full-time fully qualified GPs we had in 2015.”