The Government has unveiled the first details of the next GP contract, including an extra £889m ‘on top of the existing budget’ for general practice.
The proposals also include reducing the number of QOF targets from 76 to 44 and adding practice nurses to ARRS.
The Government will consult on its proposals for the GP contract for 2025/26 with the BMA’s GP committee ‘over the coming weeks’, before unveiling it in spring next year, it said today.
Health secretary Wes Streeting said: ’General practice is buckling under the burden of bureaucracy, with GPs filling out forms instead of treating patients. It is clear the system is broken, which is why we are slashing red tape, binning outdated performance targets, and instead freeing doctors up to do their jobs.
’We promised to bring back the family doctor, but we want to be judged by results – not promises. That’s why we will incentivise GPs to ensure more and more patients see the same doctor at each appointment.
’We are proposing substantial additional investment and greater flexibility to employ doctors so patients get better care. I call on GPs to now work with us to get the NHS back on its feet and end their collective action.’
What we know about the proposals so far
The announcement this morning was light on detail. The Government has so far proposed:
- An extra £889m ‘on top of the existing budget for general practice’
- To ‘remove red tape’ and make funding available under ARRS for ‘more primary care staff’, including practice nurses
- To reduce the number of QOF targets – from 76 to 44
- To provide financial incentives to ‘reward GPs’ who help prevent ‘the most common killers’ like heart disease
- To incentivise GPs to ensure patients ‘most in need’ see the same doctor at every GP appointment.
- It will consult on its proposals with the GPC over the coming weeks, before unveiling it in full in spring 2025
Source: DHSC
GPC England said the proposals ‘could signal’ that the profession has reached ‘the end of the beginning’ and that it is clear from the health secretary’s ‘tone’ that the BMA’s messaging and efforts ‘are starting to yield results’.
In a message this morning, the committee said: ‘We are told that the headline figure represents new money. If our modelling or calculations reveals this not to be the case, we will hold Government to account.
‘We hope this marks the start of a very long journey. We’ll be spending Christmas analysing, modelling and scrutinising ahead of commencing negotiations in the new year.’
It said that in addition to the proposed £889m uplift to the GMS and PCN DES in 2025/25, GP leaders hope to ‘secure additional money’ in the coming weeks from ‘separate pots’, ringfenced to support elective recovery.
But these funding pots fall outside the remit of the health secretary’s announcement today, according to the GPCE, which is ‘designed to provide a necessary assurance’ to practices around the ‘additional business pressures’ that they will face in the new financial year.
It comes after earlier this week the health secretary suggested that he would not reveal GP funding arrangements until ‘early in the new year’.
Mr Streeting was pressed by MPs to confirm whether GP practices and other providers would receive support to alleviate the impact of the Budget’s national insurance contributions increase, and he urged GPs not to take any decisions around their financial planning ‘ahead of seeing the allocations’.
Today’s announcement includes the headline figure of £889m but does not specifically outline compensation for the impact of the NICs hike on practices, which one LMC warned would cost English GP practices a total of £260m.
GPC England chair Dr Katie Bramall-Stainer said that the committee hopes that today’s funding announcement will be looked back on as ‘a positive starting point for an evolving conversation’.
She added that GP practices across the country have been ‘frantic with worry’ around the impact of the rise in national insurance contributions from April.
She said: ‘The BMA has shared data with Government to make clear just how grave the situation is, with practices drafting redundancy notices, and in some cases facing closure.
‘England’s GPs have been urgently waiting for a clear commitment from Government to provide assurance around increased business costs, as well as a change in direction away from the previous Government’s three consecutive years of contractual imposition which led to the profession taking historic steps of embarking upon the BMA’s collective action campaign, which has been gathering pace through the autumn.
‘Hopefully today’s news provides an important lifeline for our 6,000 plus practices, and we are committed to reaching consensus around the management of the additional business pressures that practices will face in the new financial year and we look forward to seeing the detail in due course.’
Earlier this year, the GPC outlined demands to end collective action, including GP practice core funding to rise by at least £40 per patient for 2025/26, and for a new GP contract committing to a ‘minimum general practice investment standard’.
It called for the Government to commit to a new GP contract to be implemented by April 2028 ‘at the latest’, with ‘sustained annual investment’ taking into account inflation, and uplifted year-on-year.
Dr Bramall-Stainer said: ‘We eagerly await details regarding the Government’s proposals, which come on the back of GPC England setting out exactly what is needed to rebuild sufficient GP capacity to meet patient need to deliver robust GP recruitment and retention; no further NHS GP practice closures; and an end to the crazy situation where GPs are desperately looking for work – at the same time patients are struggling to secure an appointment with a GP.’
RCGP chair Professor Kamila Hawthorne said that general practice is currently grappling with ‘intense’ workload and workforce pressures and on top of this, practices are ‘contending’ with the financial burden imposed by the NI hike.
She said: ‘As such, today’s commitment by the Government to increase the share of the NHS budget for general practice is positive news for patients and the wider NHS.
‘We are also pleased to see the focus on ridding GPs of some of the bureaucratic burden that keeps them away from patients, giving practices more flexibility around hiring doctors and nurses, and the impetus on supporting GPs and our teams to deliver continuity of care, which we know has benefits for patients and the NHS alike.
‘But while we hope this package announced today will help stabilise general practice and provide some much-needed certainty for hard working GPs and our teams, there is a long road ahead.’
NHS England chief executive Amanda Pritchard said: ‘Hard-working GP teams are delivering millions more appointments a month compared to before the pandemic, and it is vital they are given extra resources to improve access for patients and help people live healthier lives – with a renewed focus on preventing major killers, such as heart disease and strokes.
’General practice is the front door to the NHS – speaking to GPs and their teams, they are clear that embracing reform is key to improving patient experience and managing record demand.’
So, here’s a conundrum. How can you “invest heavily in General Practice” without spending a penny? Easy.
-Step 1 – announce a massive hike in NI contributions. (GPs start to panic)
.
-Step 2- announce a huge investment in General Practice that roughly equals the NI hike.(Grateful GPs relieved they will survive)
-Step 3 -when the service remains as poor as ever, claim you funded Primary Care handsomely, so direct your complaints to the selfish, greedy, incompetent doctors. (GPs realise they have been duped)
PCN GPs 138 but there were 70 prior to May so 68 ARRS. Kamila was told 300 by DHSC Pulse told they weren’t counting but NHS Digital say that they are
NI/Staff costs £40k / practice £250m already removed plus inflation £260m
So best case scenario £379m additional with caveats
I want to know where this so-called extra money is coming from – it’s not an accounting trick, ie partly from the expected NICs windfall, is it? Or they’re not robbing NHS Peter to pay NHS Paul, are they?
And where is next year’s funding going to come from? Taxes, Govt borrowing, or the private sector?
“…embracing reform is key to improving patient experience and managing record demand.’”
The nebulous reform bollocks has to stop. It’s been the consultancies’ mantra for 30yrs and it means: “We can re-mould the NHS into a commercial model for our consultancies, whilst infantilising professionals and blaming the public for getting ill”. Eg we get Babylon, isolated EPR from USA, 111 which last night meant that my 92yo mother was told there was no help after her fall, and the London IT 111/999 system doesn’t connect to Bournemouth so no reference, ETA, or update (ps that is the new reformed system), refused to send a 999 ambulance after my stroke, GPs paying £10k pa just for patients to wait in a cloud… outsourcing, stratification, fragmentation whilst speaking if integration, cuts whilst speaking of empowerment… no evaluations or analysis, just PwC, Mckinsey and KPMG .
Reform of PCG/PCT/CCG/STP/ACS/ACO/ICS…where PCNs, Neighbourhoods and LMCs are all rendered ineffective beneath central DHSC/NHSE control…
Where reform is utterly meaningless, except to inject the notion that actually rebuilding the NHS so it works again is anathema.
‘Leaders’ who speak of “reform” without definition or evidence are complicit morons who should not be in (expensive) posts.
We’ve had reform up to our ears and it’s made us deaf to important realities: reform is what has failed. How much desperately needed money has been wasted on tendentious pointless reform. We have evidence and reports, nuts and bolts of good medical/social care. The corporate mentality has literally sucked the life-blood out of the NHS.
God save us from the likes of Milburn and vested political advisors; they are actually the biggest hindrance to NHS recovery.
Reform is a euphemism and has lost its actual meaning. Bring back the profession.
GP budget needs to increase by at least 50%. end of. Otherwise work properly to rule. Nothing that is not contracted. end all shared care. BMA have a list of what the contract does stipulate for. Most of what we do is not on that list. Work to rule properly. end of. They settled the train drivers, the consultants, the juniors. This government is a party based on collective action by workers. The workers here, the GPs, need to follow suit. End of
Step in right direction. I was hoping they could do some thing about out of hours service. . Main reason for a & e crowding.
More tinkering, more money spaffed; will fix nothing.
But might allow some to retire a little earlier and escape the ghastly NHS if the increase is genuine.
@nick.mann 👏.
Milburn, Corrigan….and now (Niccolo) Mandelson, the Prince. All the wrong signalling by BLairabour.
Nick Mann nails it. Management Nirvana, patient hell