NHS England recently published a letter outlining details of the 2024/25 GP contract. Not many of us were expecting a huge windfall for practices this year, but even so, it was still a shock to find out just how little is being invested in general practice in the coming year.

In this month’s podcast, I discuss the details of the letter with Robyn Clark and Claire Houston. It’s the third consecutive year that no deal has been reached between the GPC and NHS England, and so it’s the third consecutive year that a contract has been imposed on the service. Given the paltry uplifts on offer (2% overall, using an inflation rate of 1.68%!), it’s no surprise that the GPC rejected the contract out of hand, but reaching an agreement with the GPC no longer seems to be of any concern to either NHS England or the Government.

There are steps in the contract designed to improve the cashflow of practices. The aspiration payment threshold for QOF is being raised from 70% to 80%, and the 30% discretionary part of the Capacity and Access payment (which is being increased and has now almost entirely replaced the PCN Investment and Impact Fund) will be paid in year once the PCN Clinical Director confirms compliance across all the practices in the PCN.

But as our panel point out, improving cashflow doesn’t really help if there’s insufficient funding coming in the first place!

Access (unsurprisingly) remains a huge national priority. Part 2 of the Modern General Practice Access Delivery Plan is on its way, and we wait to see what horrors it contains. There will be a mandatory national data extraction from digital telephony systems from October this year, looking at eight metrics such as number of calls abandoned, call-backs requested and call-backs made. While the purpose of this is “to better understand overall demand on general practice”, our panel were under no illusion that this is for anything other than to performance manage practices.

PCNs, meanwhile, look like they’re here to stay. The ARRS continues with no meaningful uplift and with very few changes. “Enhanced nurses” are the only new role that has been included, but we’ll have to wait until the full details arrive (doubtless after 5pm on the last working day before Easter!) to find out what these actually are.

The PCN CD payment and the PCN Leadership and Management payment are being combined and included within core PCN funding. This is purportedly to give “greater autonomy” to PCNs, but our panel were concerned that this could lead to even more opaqueness locally regarding how PCN funds are being used.

It’s hard to generate any enthusiasm for a contract that so explicitly undervalues general practice. The funding may increase depending on both what the DDRB (Doctors and Dentists Review Body) recommends and what the Government’s response to these recommendations is; but rather than providing hope, this just creates more uncertainty for practices and their staff. The letter also states that a “Taskforce on the Future of General Practice” will convene over the spring and summer – one guesses to review the damage the underfunding of recent years has caused and to see what future torments can be concocted to inflict upon the service.

Which all leads to the prospect of industrial action. The service surely cannot accept such a contract, and we wait to see what measures the GPC proposes. In the meantime, the priority must be for everyone who can participate in the BMA referendum to do so, so that the GPC at least has a mandate for taking action.