All eyes were on NHS England recently and the announcement of the final GP contract in England for 2016/17. Amid plenty of fanfare, and no doubt keen to divert attention away from the Junior Doctor mess, the governing body was eager to shout about the new contract’s £220 million investment, part of which will pay for a 1% pay uplift for GPs.

What’s more, health secretary Jeremy Hunt said, not for the first time, that this new contract is “the start of a process for investment, support and reform in general practice… with a bigger package due to be announced soon” – expected to be in the next few days.

The detail

So what is the £220 million going to be used for and what does it mean for practices? Changes to the 2016/17 contract include:

• Increased investment of £220 million into the GP contract to deliver a 1% pay uplift and reimbursement to meet rising expenses facing practices, including higher CQC fees, practice upkeep and staffing costs.
• An end to the dementia enhanced service with a transfer of £42m resources to core funding.
• No new clinical workload schemes or changes to the QOF
• Joint commitment to explore the end of the QOF and ‘Avoiding Unplanned Admissions’ enhanced service.
• A commitment to a national strategy to reduce bureaucracy and manage demand on GP services.
• A 28% increase to the vaccination and immunisation item of service fees from £7.64 to £9.80.
• GP practices will be required to record data on the availability of evening and weekend opening for routine appointments, which is to be collected until 2020/21.
• GP practices will record annually the number of instances where a practice pays a locum doctor more than an indicative maximum rate, as set out by NHS England.

QOF points

One of the key points for practices is the change to the value of QOF points. For 2016/17, NHS Employers and GPC have agreed that there will be no changes to the number of QOF points available, the clinical or public health domains or QOF thresholds. However, the Contractor Population Index (CPI) will be adjusted to reflect the changes in list size and growth in the overall registered population for one year, from 1 January 2015 to 1 January 2016. The adjustment to CPI will inform an increase to the value of a QOF point for 2016/17. The national average list size as of 1 January 2016 is 7,460 and the value of a QOF point for 2016/17 will be £165.18.

Real value

So what does this increase mean in real terms? Practice Index contacted a practice manager to see how the figures stack up and these are our findings:

Based on the information available, the practice, which has a list size close to the average of 7,500, estimates that income will rise by around £10,500 per year. However, there are a number of costs to take into account for the 2016/17 year. They include:

• Increased indemnity insurance, which the practice says will be about 20% (£7,500 increase)
• A rise in staff costs due to the introduction of the National Living Wage, which will equate to close to £600 a year.
• Extra pension costs (£500)
• CQC fee uplift of at least £1,800

So, this instantly wipes out the increased revenue from the new GP contract, and that’s before other expenses such as pay rises, price hikes from suppliers also needing to deal with the cost of the National Living Wage and property costs, to name just a few.

“In reality, even before inflation is taken into account, it’s another pay cut for GP practices,” a practice manager told us. “It’s another example of NHS England giving with one hand and taking away with the other. We’ll have to see if Jeremy Hunt actually delivers something meaningful in his rescue package but it that doesn’t hit the mark we’ll have to consider our options for the future, including walking away.”

Increased bureaucracy

Aside from complaints about the meaningless uplift in income, other practice managers are complaining about the introduction of yet more bureaucracy – it will become a contractual requirement for practices to record data on the availability of evening and weekend opening for routine appointments, every six months until 2020/21.

GP practices will also be required to record annually the number of instances where a practice pays a locum doctor more than an indicative maximum rate, as set out by NHS England.

We’ll be watching out for news of Jeremy Hunt’s rescue package – but in the meantime more information on the 2016/17 GP contract can be found here.

We would love to hear your views on the new GP contract. Share your thoughts below or head to the Practice Index Forum thread here.

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