With almost £1bn extra in core funding, there is a lot to be welcomed in the new contract for England practices. There are, however, some issues that as specialist medical accountants we will be viewing more cautiously, notably the new state-backed indemnity scheme.
‘The indemnity scheme will be funded by a one-off permanent deduction from the global sum and will cover all GPs and staff, including locum doctors. Since locums will no longer need to pay for their own indemnity cover they have been asked to consider their rates. If locum rates do not reflect the new indemnity arrangement GP partners will pick up the cost twice; once through the reduction in the global sum and again through the locum fee. AISMA raised this during discussions with NHS England and the BMA. Urgent guidance is required on setting responsible locum fees.
‘The contract agreement does not refer to the increase in funding required for the proposed 6.3% increase in employer contribution rate. It is important that the proposed changes to the NHS pension scheme regulations 2019 are viewed alongside the new GP contract.
‘Also needed will be guidance on the legal and pension structures of Primary Care Networks so that it is clear where responsibility for contracting and employment rests.’
Key points to note are listed below, but as always the devil is in the detail. We will be advising our clients accordingly once the full 'technical briefing' is issued.
- With £1bn extra in core funding for practices in England across five years, is this the gamechanger?
- £405m investment through the practice contract and 'network contract' in 2019/20, meaning every practice will be able to uplift staff pay by at least 2%
- Overall investment of £1bn core funding over the five years
- Establishing primary care networks across England by July 2019, backed by £1.8 billion of funding by 2023. Networks will be led by a local GP in a clinical director role.
- Primary care networks will receive 100% recurrent funding to employ social prescribers and 70% for clinical pharmacists in 2019/20, and the same for physiotherapists, physician associates and paramedics as they are introduced.
- The introduction of a state-backed indemnity scheme beginning in April 2019.
- Increased digital access for patients, meaning practices will make 25% of appointments bookable online, improve their online presence and give new patients access to their digital records as standard.
- An agreement between the BMA and NHS England to make joint representation to the Government with proposals to reduce the problem created by the pension annual allowance, to address the impact this is having on GP recruitment and retention.
- NHS 111 direct booking in to practice appointments at a rate of one appointment per 3,000 patients available per day. This will happen only after triage.
- Funding for practices to deal with subject access requests following the removal of the ability to cover costs under GDPR legislation. Practices will also have access to a data protection officer (DPO) through their CCG, to provide support on GDPR issues.
- QOF changes to remove unnecessary indicators and provide a focus on professionally-led quality improvement.