The BMA’s GP committee has urged the Government to ‘stop disinvestment’ in general practice and increase its proportion of NHS funding by 1% year on year.
GPC England chair Dr Katie Bramall-Stainer made the demands today in a letter to new health secretary Wes Streeting, warning that ‘erosion’ to contract baseline funding value is ‘at a nadir’.
She said that the Government should ‘start a journey’ to increase the proportion of funding to general practice ‘by 1% year on year’, moving towards 15% ‘incrementally’.
The letter also urged the Government to work with the GPCE to agree ‘a 2025 Family Doctor Charter’ paving the way for ‘a new substantive contract’ for general practice ‘to be delivered within this Parliament’.
The letter said: ‘Stop disinvestment in practices which has led to the loss of almost 25% of practices in 14 years.
‘Reverse the decline of the past five years of GP practice contract funding value erosion with a roadmap towards a minimum general practice investment standard.
‘Start a journey to increase the NHS proportion of funding to general practice by 1% year on year, incrementally moving towards a proportional funding floor of 15p per NHS pound for primary medical services including neighbourhood health centres.’
Labour’s manifesto carried no immediate promises of increased investment in general practice but the party previously said it wants to shift more money to primary care over time.
Dr Bramall-Stainer told the health secretary she has been ‘heartened’ by Labour’s campaign messages around how the proportion of NHS spend ‘needs to shift from reactive hospital-based care to proactive care in the primary and community setting’.
She added: ‘In England, general practice receives almost 7p in every NHS pound. At an individual patient level, an average GMS core contract payment equates to £107.57 per annum, around 30p per day. It’s no wonder practices are closing.
‘This is why GP contractors and partnerships are returning their contracts to commissioners – they’re no longer financially viable.’
The letter also urged the Government to make it easier for practices to hire GPs.
In the ‘immediate short-term’, the Government should work with the GPC to ‘develop a practice-level reimbursement scheme’ to ‘redistribute network resources transparently into core practice funding’ and allow recruitment and retention of GPs and practice nurses.
Dr Bramall-Stainer added: ‘Our amazing practice nurse colleagues deserve parity of terms with their trust-employed colleagues.
‘In our recent survey of unemployed GPs, 80% of respondents stated they want to do more NHS GP work but are struggling to find it. Getting these highly-qualified GPs into practice roles must be an absolute priority for everyone, and we have solutions for this.
‘Remove harmful red tape preventing practices employing the roles they need, and patients want. Continuity of care saves lives, and patients want to see a GP – if possible, their GP. Let’s listen to patients and bring back their family doctor.’
Ahead of the election, Labour pledged to review the additional roles reimbursement scheme (ARRS) and also to cut GP bureaucracy. Its election manifesto also said it would return the family doctor, but had little detail on how this would be achieved.
The GPC’s asks
- ‘Start a journey to increase the NHS proportion of funding to general practice by 1% year on year, incrementally moving towards a proportional funding floor of 15p per NHS pound for primary medical services including neighbourhood health centres’
- Remove ‘harmful red tape’ preventing practices employing ‘the roles they need, and patients want’
- Work with the BMA’s GP Committee England to agree a 2025 Family Doctor Charter – it ‘would signal much needed hope to patients and the profession alike in agreeing heads of terms for a new substantive contract for England’s general practice to be delivered within this Parliament’
- Practices need GP to patient list size ratios to ensure manageable workloads and patient safety
- Scrap the personalised care adjustment to childhood immunisations and ‘wipe away bureaucracy and red tape that perversely affects those serving our most deprived communities’
- Provide profession and patient confidence in the ‘integrity of the GP patient record’ via ‘better and wider data-sharing’ via platforms such as OpenSAFELY
- Support GP contractors by extending the Clinical Negligence Scheme for General Practice (CNSGP) to ‘provide protection for practices when sharing data in good faith for NHS purposes’
Source: BMA
Dr Bramall-Stainer’s letter also renewed calls for ‘GP to patient list size ratios’, pointing out that patient list sizes ‘have grown far beyond safe levels across England’ and that most GPs deliver more than 25 appointments per day, contrary to BMA guidance.
Dr Bramall-Stainer said: ‘Our survey showed that only 10% of respondents deliver 25 or fewer appointments on a typical day.
‘88% of respondents deliver 26 or more, with 52% delivering between 31 and 50. Improving general practice capacity to facilitate continuity of care through safe patient list sizes will provide the best, as well as the most cost-effective care for our nation.’
Labour’s election manifesto pledged to ‘reform’ primary care, trialling ‘neighbourhood health centres’ which would have GPs and other community health staff ‘under one roof’.
Shortly after Mr Streeting was appointed on Friday, the the BMA called on the Government must agree a new GP contract with the BMA ‘to stabilise primary care’ in England.
and change punitive taxation and superanuation regime. as partner I need to earn more than twice as much as my salaried GPs earn gross in order to receive drawings comparable with their net pay.