Government imposes GP Contract Changes without agreement
The changes to the GP contract in England announced last week, fail to help patients and support practices at this critical time says the BMA.
Despite negotiations between the BMA and NHS England, the changes, laid out in a letter from NHS England today and which come into effect from 1 April, have not been agreed or endorsed by the BMA.
The BMA and NHS England began negotiations this January over annual amendments to the five-year contract deal agreed in 2019, and discussions around what further support was required for general practice as it faces unprecedented pressures and pandemic recovery.
During negotiations, the BMA consistently laid out a number of solutions to address some of these pressures, enabling practices to support patients. These included:
- Additional funding to cover increased employers national insurance contributions (due in April) as well as the increased pressure from rising inflation. Without resources, practices will lose staff for frontline patient care;
- Flexibility for Primary Care Networks to hire the professionals that they need locally based on the needs of their patients, and not be bound by rigid, prescriptive job roles;
- A funded pandemic recovery plan that reflects the emphasis and urgency placed on the elective recovery plan in secondary care.
These negotiations reached a stalemate in mid-February when it became clear that NHS England would not be offering an update that would impact meaningfully on patient care.
Further conversations emerged between the BMA and government, and culminated in a meeting with the Secretary of State for Health and Social Care. Yet today’s letter, presented to the BMA just hours before being sent to the profession, fails to make progress in any of the key areas outlined above.
Dr Farah Jameel, BMA England GP committee chair, said:
“We are bitterly disappointed that NHS England has chosen to ignore the appeals from the profession and the needs of patients in today’s letter.
“Despite our best efforts to outline a number of positive and constructive solutions that would make a difference to practices’ ability to improve care for patients, NHS England has instead decided to follow a path laid out three years ago, long before the arrival of Covid-19, and roll over a contract that fails to address the current pressures faced by general practice.
“Failing to offer practices something as simple as reimbursement to cover additional costs for national insurance contributions means they are losing funding that should be going towards looking after patients. Therefore, a tax aimed at funding the NHS, has become a tax on the NHS itself. The result will be fewer members of staff to care for the growing needs of patients.
“Today’s letter attempts to sell the changes as stability. Whilst stability is important, the reality is that general practice needs an emergency rescue package. Without this emergency life support, patient care will suffer. The waiting lists currently seen across the NHS are now going to become more of a reality in general practice.
“We approached this year’s negotiations in good faith, recognising the need to uphold previous agreements but striving for improvements in patient care. Today’s letter, presented to us with only a few hours’ notice, defies everything we were aiming to achieve in building a constructive relationship and sits at odds with positive conversations with government.
“GPs and practices will see today’s changes as devaluing their goodwill and demolishing their spirit. The letter does nothing to capture the scale of changes needed nor safeguards patients, and further highlights the need for a new contract that delivers high quality safe care in the new world we live in.”