A NEW 2015/16 contract was signed by NHS Employers and the BMA’s GP committee on 30th September. However, there is nothing in next year’s contract to address the desperate shortage of 8,000 GPs.
In fact, government policy is to strangle traditional GP practices through underfunding so that more and more of them face closure. They are then pushed into merging into federations.
This is in line with the long-term plans of both Tory and Labour parties to set up large ‘out-of-hospital providers’.
The new contract renews the extra funding arrangement by which GPs provide particular care for complex patients, so as to prevent them going into hospital.
This ‘Unplanned Admissions Enhanced Service’ was a feature of last year’s GP contract. The aim of it was to reduce so called unnecessary emergency admissions to hospital.
The most at risk 2% of the practice population must receive ‘proactive case management’. These patients are picked out through risk stratification and are put on a case management register.
Such patients might include vulnerable older patients, those with complex health needs including children, patients who are dying, and those who are at risk of emergency admission to hospital.
These patients have personalised care plans and a named accountable GP and a care co-ordinator to keep in contact with the patient.
Practices have to make regular reviews of all emergency admissions to hospital to identify factors which could have prevented the admission, and submit reports to the CCG and the Local Area Team.
The new contract also states that there must be a ‘named GP’ for every patient. Patients must be able to contact the surgery by email, and a greater proportion of appointments should be made available for patients to book on-line.
GPs must also publish their net earnings. Seniority payments have been reduced by 15%. Also, practices will have an automatic right to funding for locums to cover maternity and paternity leave.
Payments GPs receive through the Quality and Outcomes Framework (QOF) will remain unchanged.
GP practices will be expected to run patient participation groups and keep special records of patients with alcohol problems without the extra funding that they had before.
On the crucial issues of renovating GP premises, which in many areas are run down and in desperate need of refurbishment, the issue has been kicked into the long grass with a promise of ‘strategic discussion’.
Likewise, on the acute crisis in GP recruitment the proposal is to ‘work together on workforce issues’.
