The Government’s contract funding boost for general practice is intended to cover any extra costs from National Insurance Contributions (NICs), according to GP leaders.
Members of the BMA’s GP Committee England told Pulse that costs associated with the Autumn Budget changes are factored into the almost £800m funding boost to the global sum announced last week.
The BMA recently calculated that planned increases to NICs and the National Living Wage (NLW) in 2025/26 would cost GP practices between £180-200m nationally, and many GP leaders and politicians have been pushing for practices to be fully reimbursed for these extra costs.
Neither the BMA nor the Government mentioned National Insurance pressures in their contract announcements at the end of last week, but Pulse understands that the extra core funding next year is the full extent of support for practices to cover tax changes.
Dr Paul Evans, GPCE member and chairman of Gateshead and South Tyneside LMC, said the committee had been told that NICs and NLW costs were ‘bundled into’ the contract deal funding and that this indicates there will be no exemption for GP practices.
‘I think with the NI stuff having been explicitly bundled into the funding for this year’s contract, they’re not going to exempt practices,’ he told Pulse.
Dr Evans said the funding boost ‘is not going to be transformative’ but that it is a ‘one-year deal’ which is ‘going to stop things getting worse, for the time being’.
He continued: ‘I think most practices will see some benefit. It won’t be enormous. And clearly every practice is different, because we’re all different size. Some are your partner practices or single handed. Some are on an all salary model. Some practices use ARRS staff more than others. So there will be practices that do better than others off it.
‘But I don’t see that this should be a problematic contract for many practices from a financial point of view. It’s not going to put us back to where we were financially a few years ago, but it’s stopping things getting worse.’
Dr Chandra Kanneganti, GPCE member and North Staffordshire LMC chair, also confirmed that the 2025/26 contract funding boost represents the extent of NICs support for practices.
He said that the impact of this funding will be different for every practice since there are lots of different ‘variables’ each practice will need to ‘calculate to see whether this contract will cover their expenses and if it is really proportionate to inflation’.
An amendment to the National Insurance Contributions bill was passed in the House of Lords last week, which would freeze contribution rates for GP practices at the amount previously paid (13.8%), rather than the proposed rise to 15%.
However, the amendment would need to also be backed by MPs in the House of Commons in the next stage before the bill receives Royal assent.
Dr Kanneganti told Pulse: ‘I would’ve hoped that we get a proper NI reimbursement by the Government. The House of Lords has proposed an amendment and if the Secretary of State really wanted to support general practice, he would support the House of Lords amendment to reimburse the National Insurance costs completely like they’re doing for other NHS bodies.
‘That’s what they should do if they really wanted to support general practice.’
Pulse has contacted the Department of Health and Social Care (DHSC) for comment.
So we need to start talking about £600 million not £800 as the 200 million is fantasy money they’re taking with one hand via NI and giving back with the other. It’s clear this contract is not going to stop the rot in primary care at best it will slow the current rate of decline. Waiting potentially until the end of this parliament for a wholesale new contract highlights that primary care is not either NHSE or the government’s priority.
And a significant portion of the other £600 million is transferred QOF money rebadged as core contract and therefore not actually an uplift at all. While making it harder to reclaim the other moved QOF finance.
ND and GR – spot on. Subtract minimum wage increases also and I would think £800m becomes more like £400m.
Another option would be to remove the restriction on the national insurance employers allowance and make it available for GP Practices and all NHS subcontractors, charities etc. Many are small medium businesses and if their business involves greater than 50% nhs work, the ni allowances are not allowed.
So about £9.50 into global sum / patient.
In our practice:
£3 for National Insurance increase / patient.
£3.80/patient if staff get a 4% pay rise at some point.
That leaves £2.70 / patient before any other inflationary rises in exchange for stronger guarantees triage is always open.
The usual NHS England smoke and mirrors.
No clarity to the general public that this is in fact a trivial rise once the recycling of QOF points and NI rises are taken into account.
How on earth is this trivial rise meant to “stop the 8am scramble”?
So already it comes out, its not a 7% uplift – its actually only 5% !
Foxtrot Oscar NHSE – collective action continues with negotiators like this 🙁
How disappointing. Self-employed farmers take angry visible action but the BMA can only suggest GP principals pause ineffectual collective action. Is it the BMA’s plan to keep the public in the dark about general practice suffering and patients getting sh*t access/care because of Govt decisions?
Funnily, they have the political will to find billions for “defence” “war” at the drop of a hat over the last few days. When will the BMA organise action and protest? Hopefully before general practice is dead..