A real game changer for General Practice

Today we have agreed a new five-year GP contract framework with the General Practice Committee of the BMA. 

You will have seen in announcements surrounding the NHS Long Term Plan, a commitment to invest £4.5bn more in primary medical and community health services by 2023/24. The new contract is the first part of implementing the NHS Long Term Plan, reflecting the true primacy of Primary Care. However, many of you have asked for more details, so I have summarised these below.

I know how challenging it feels, every day, in general practice. I know how complex it feels, and how frustrating. I also know how rewarding it is. There is simply no greater joy than to be able to do the job you trained to do, and to work in general practice.

We talk often about strong or sustainable general practice. The new contract framework marks some of the biggest general practice contract changes in over a decade and will be essential to support genuinely strong and sustainable general practice services.

The contract increases investment and certainty around funding and looks to reduce workload and workforce pressure. It also will ensure general practice plays a leading role in every Primary Care Network (PCN) which will include bigger teams of health professionals working together in local communities.

Here is a short summary of key parts of the contract:

  • Core general practice funding will increase by £978 million per year by 2023-24.
  • A new state backed indemnity scheme will start from April 2019 for all general practice staff including out-of-hours.
  • Improvements to the Quality and Outcomes Framework to bring in more clinically appropriate indicators such as diabetes, blood pressure control and cervical screening. There will also be reviews of heart failure, asthma and mental health. In addition, there will be the introduction of quality improvement modules for prescribing safety and end of life care.
  • Additional funding of IT will allow both patients and practices to benefit from the latest digital technologies. All patients will have the right to digital-first primary care, including web and video consultations by 2021. All practices will be offering repeat prescriptions electronically from April 2020 and patients will have digital access to their full records from 2020.
  • A Primary Care Network (PCN) contract will be introduced from 1 July 2019 as a Directed Enhanced Service (DES). It will ensure general practice plays a leading role in every Primary Care Network and mean much closer working between networks and their Integrated Care System. This will be supported by a Primary Care Network Development Programme which will be centrally funded and locally delivered.
  • By 2023/-4, the PCN Contract is expected to invest £1.799 billion, or £1.47 million per typical network covering 50,000 people.  This will include funding for 20,000 more health professionals including additional clinical pharmacists, physician associates, first contact physiotherapists, community paramedics and social prescribing link workers. Bigger teams of health professionals will work across Primary Care Networks, providing tailored care for patients and will allow GPs to focus more on patients with complex needs.

More details are available on the NHS England website and please check out our animation which is great to share with your practice teams, and keep reading for more information on the elements above.

This really is a game changer for general practice, and the beginning of a new era.

  • This article was first run in the latest GP Bulletin for January.
  • You can follow Dr Kanani on Twitter: @NikkiKF

Dr Nikki Kanani is a GP in south-east London and is Medical Director of Primary Care for NHS England and NHS Improvement. Prior to joining NHS England she was Chief Clinical Officer of NHS Bexley Clinical Commissioning Group (CCG).

Nikki has held a range of positions within healthcare to support the development of innovative models of care, highly engaged clinical, patient and public leadership and is passionate about supporting primary care, improving service provision and population wellbeing.

She is a member of The King’s Fund General Advisory Council and holds a MSc in health care commissioning. With her sister she co-founded STEMMsisters, a social enterprise supporting young people to study science, technology, engineering, maths and medicine. She has two young children.

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