Northern Ireland’s GPs are set to see the full £38.9m worth of QOF funding repurposed for core services and indemnity cover this year.
As the final details of the 2024/25 contract – effective from 1 April – were agreed, the BMA’s GP Committee said negotiations had concluded ‘successfully’ but that there was more to be done.
They highlighted key benefits of the contract deal as a ‘much-needed simplification of current arrangements’ and ‘more streamlined funding’.
But the NI health minister admitted the overall budget allocated for the NHS had not allowed for a ‘substantial’ increase to the ‘overall value’ of the contract.
Full papers are yet to be published, but the DoH and BMA outlined the key details of the deal as:
- QOF will be replaced with a Clinical Care Domain in the NI Contract Assurance Document, with the associated funding incorporated into the ‘core’ GMS contract. GP practices will be required to provide these services to their patients as clinically appropriate.
- A number of specified Enhanced Services will also be moved into the Clinical Care Domain of the NI Contract Assurance Document, with the associated funding incorporated into ‘core’ in the same way as QOF.
- Some of the items that are now in core funding include additional monitoring of amber drugs, alcohol, clinical waste and chronic respiratory funding.
The total funding that will be released as a result and available for re-purposing is £38.9m.
- Of this, £5m will be dedicated to GP Indemnity, as an interim measure, pending identification of the long-term model for future provision.
- The £5m will be shared on a capitation basis among practices and will mean an average uplift of £15.9k per average practice – to be paid at the start of this financial year to help cash flow.
- The remaining £33.9m will be added to core Global Sum payments made to practices based on April 2024 patient lists.
According to the DoH, assurance over ‘the required level of care being delivered to patients’ will be provided through the new NI Contract Assurance Framework (NICAF). However, the full workings of the NICAF are yet to be finalised.
In addition:
- Practices will now see the bulk of their funding paid in 12 monthly instalments to help with cashflow and budget planning.
- No practice will lose any of their current income as there will be a ‘financial floor’ for everyone, the BMA stated.
Health minister Robin Swann said he has been ‘clear’ since his return to the role earlier this year that ‘support for GPs and wider primary care is a key priority for me’.
‘Stabilising GP services is of crucial importance and I believe this contract is a step forward in that regard. There is, of course, much more work to be done.
‘Whilst the budget provided to me by the Executive does not allow me to make a substantial increase in the overall value of the contract, I am pleased that the agreement announced today makes significant progress against key aims identified by GPs in their negotiations, including provision of dedicated funding for their indemnity costs.
‘I would pay tribute to the constructive and imaginative approach taken by NIGPC leadership throughout these negotiations.’
The BMA’s lead negotiator and NIGPC chair Alan Stout said: ‘When we entered negotiations we were clear that we had three aims; to simplify the contract, to ensure a fair uplift and to make significant progress on indemnity.
‘We have managed to negotiate successfully in these key areas for this year, and we secured a commitment from the Department and SPPG to further review the contract for subsequent years.’
He pointed out that ‘equalising the indemnity provision for GPs in Northern Ireland’ – which is the only country where GPs have no state-backed scheme – has been a ‘red line’ for the negotiators.
‘We will continue to work with the Department to bring forward a longer-term indemnity solution that ensures we have parity with the rest of the UK,’ he added.
Regarding the upcoming Assurance Framework, he said the BMA has ‘worked hard to make sure that this is a “light touch” assurance framework, not more work for GPs and their teams to complete’.
‘Negotiating these changes has been challenging. We have not achieved everything we know needs to be done and we will continue to work on a new fit for purpose GMS for 2025 onwards,’ Dr Stout added.
Around one in three GP practices across Northern Ireland sought ‘crisis support’ over the last four years, the country’s public spending watchdog revealed in March this year.
A version of this story first appeared on our sister publication Pulse.
