NHS England has proposed linking more funding to access measures and mandating practices to offer automated access to patient records by 31 July in its 2023/24 GP contract offer.
Last week, the BMA’s GP Committee said it was considering industrial action following NHS England’s offer for the 2023/24 GP contract, calling it ‘insulting’ and a ‘slap in the face’ for GPs.
The GPC statement revealed that there was no increase in funding for general practice, despite the increase in cost of living.
Other details in the 2023/24 GP contract offer included:
- £305m in the investment and impact fund (IIF) – the incentive fund for PCNs – including:
- £246m for a capacity and support indicator, which involves things like patient experience and patients being seen with two weeks or less;
- £59m for clinical indicators, such as cancer and flu;
- An access marker added to the QOF, plus the inclusion of the cholesterol-lowering injection, Inclisiran;
- Forced prospective access to records for all patients from no later than 31 July 2023;
- No uplift to childhood immunisations or global sum, and pushing forward with pay transparency.
The current contract was introduced in 2019, for a five-year term, but there have been negotiations for minor changes throughout the term.
The GPC statement had revealed that there was no increased uplift beyond the 2.1% agreed as part of the five-year deal, despite the huge increases in inflation.
However, the other elements of the deal could prove to be just as controversial.
The emphasis on access in the IIF and QOF is the latest in the long-running push by NHS England and ministers to place the burden of increasing access on GPs.
Analysis this year revealed that practices who offer more face-to-face appointments on average have longer waiting times and less consultations with GPs, suggesting that the problems with access are systemic.
The increased funding in the IIF – which currently stands at £260m – also reflects an increased emphasis on funnelling funding through PCNs, despite growing opposition to networks.
There has also been strong criticism from GPs about the childhood immunisations payment scheme, which sees practices especially in deprived areas missing out on funding based on a few families declining to have the vaccinations.
Automatic access to patients’ prospective patient records had originally been due to be switched on by the end of November, following delays related to concerns about patient safety. However, this was later delayed indefinitely with this latest contract offer being the first indication since around a new launch date of 31 July this year.
However, the main source of contention remains the lack of increased funding. This week it was reported that NHS England has suggested that the Review Body for Doctors’ and Dentists’ Remuneration (DDRB) should recommend a 2.1% increase in salaried GP pay in 2023/24 to reflect the uplift in practice funding.
The next steps will be further negotiation between NHS England and the GPC. However, if there is no agreement, GPC has indicated it will be willing to pursue industrial action.
NHS England said that negotiations are ongoing, and the BMA has declined to comment.
A version of this story was first published on our sister title Pulse.