LMC Update – 12 August 2024

GPC Englands vision to rebuild general practice

We have published our Vision for General Practice which outlines key short, medium and longer term asks of the new Government framed around safety now, stability for next year’s contract and longer-term hope in negotiating a new substantive contract for general practice in England.

Our vision has been informed by our conversations with thousands of GPs across our roadshows in recent weeks and responding to the manifesto commitments from the new Government where we have an opportunity to repair trust and rebuild general practice.

NHSE Potential collective action by GPs:  supporting guidance

Many colleagues will have seen this guidance by NHS England on potential collective action by GPs, which is been reviewed by GPC England and an update will be circulated shortly.

Other National Updates

DDRB announcement

This year’s investment into national GP practice contract funding to support DDRB recommended pay uplifts for 2024/25 is a welcome step forward.

However, the formula that’s used allocates funding per patient for each individual practice, and is based on criteria like the age and sex of patients and where the practice is located. Instead, staff costs should reflect the diverse skill-mix needed to deliver the full range of patient care within each individual practice. Partners will want to reward all their staff for their dedication and commitment, but while some practices may receive enough to pass on a full 6% salary uplift, others won’t, forcing them to make difficult choices about what they can and can’t afford to give hardworking staff.

We have raised these issues repeatedly with DHSC and NHS England. For years, GPs have been expected to do more with less, but practices can’t make insufficient funding stretch any further and staff morale, recruitment and retention is suffering as a result. This inevitably contributes to longer patient waiting times, poorer outcomes and widening health inequalities across England; the very opposite of GPC England’s vision for the future of General Practice.

When we negotiate the new GP contract – which we have publicly stated we expect to do with the new Government in this Parliament – we will seek to devise a better mechanism for allocating annual DDRB uplifts. Investment must be distributed fairly and equitably so that every hard-working staff member gets the annual pay uplift they deserve wherever they work in England. In the meantime, we will continue to work with DHSC and NHSE to develop short, medium and long-term solutions to give patients and practices safety, stability and hope.

ARRS funding scheme expansion

Following the recent announcement from the DHSC and the secretary of state on the temporary inclusion of newly or recently qualified GPs in the ARR Scheme, GPC England provided a joint statement with the Sessional GPs Committee highlighting the potential impact of expanding funding to include GPs, and raising our concerns about the practical implementation of this:

‘There are experienced and talented GPs, ready and able to work, but practices can’t afford to hire them so expanding the funding scheme to include GPs shows the Government is keen to find solutions to stabilise general practice. However, we have concerns around how this policy will work in practice, and it’s fundamentally nowhere near enough to save general practice. Because the funding won’t be allocated at a practice level, but instead via Primary Care Networks, this means any GPs employed through this scheme could be forced to move across the country at short notice, uprooting their families in the process, and depriving their patients of continuity of care. This in itself could drive more GPs away from the NHS.

‘We’ve shared ideas with the Government for how to best get more unemployed GPs back into the workforce, because there are more flexible and effective ways that this funding could be used to ensure the maximum benefit for patients – for example reimbursing the practices themselves. In the long-term, however, we need to see the core GP contract funding increased so that practices have full control over who they recruit, without the need to go via bolt-on schemes. We will continue to share suggestions with the new government to potentially take forward in 2025/26.’

We continue to call on the new government to listen to the concerns of GPs and to act swiftly to restore and enhance the cornerstone of effective healthcare – our general practitioners.

PCN Pilots – S96 guidance

Following requests from LMCs and practices GPCE has sought advice on the Section 96 Agreement that is being sent out to practices to sign up to participation in the PCN Test Pilots.  This sets out a number of concerns with the proposed Agreement raised following legal consultation.

In line with our recommended list of collective actions, we would strongly urge practice to defer making any decisions to accept local or national NHSE Pilot programmes whilst we explore opportunities with the new Government. Read our guidance.

Crowdstrike outage

Following the events of Friday 19 July that saw critical digital services, including in general practice, across the country impacted by the outage. GPC sought and received assurances from the ICO and NHS England that GPs would not be required to report the availability breach to the ICO created by the outage on an individual basis. Instead – NHSE is providing a bulk report to the ICO, allowing them to satisfy their obligations under Article 33 (1) UK GDPR. The ICO confirmed that for those practices that have already reported, they may consider the matter closed with no further action to follow. However, any breaches unrelated to the crowdstrike outage and its impact on EMIS will still need to be reported.

New GPCE guidance on Physician Associates (PAs) working in general practice

We have published guidance to help standardise practice and reduce variation in how physician associates work within a general practice setting. It aims to provide a framework to support physician associates to work safely in general practice, for patients, their employers, and GP supervisors.  It has been designed to complement the scope of practice and supervision guidance already published by the BMA and should also be read in conjunction with GPCE’s Focus on MAPs in general practice.

Are your pension records up to date?

The BMA’s Pensions Committee have launched a campaign encouraging you to take action to make sure that your pension records are accurate and up to date, so you can make informed decisions about your pension savings, retirement plans and the McCloud remedy.  We are aware that thousands of GPs in England have “missing years” of pensions data due to PCSE’s maladministration of pension records. We have been consistently highlighting the failures of PCSE (run by Capita), and the significant importance of them fixing this issue as soon as possible. Unfortunately, there has not been sufficient progress to resolve this issue, so we are now encouraging you to take action to get your pension records in order.

To support you the Pensions Committee have created detailed guidance including template letters to help you get your records up to date, raise a complaint and escalate further where appropriate. Guidance on getting your pension record up to date, for GPs in England – YouTube

UK Visa Sponsorship Licences (formerly known as Tier 2)

Does your practice have a visa sponsorship licence? Do you what it is or why you might want one?

This podcast will persuade you to push this up your practice list of priorities as something to have in place! Listen now to find out why. Wessex LMCs joint CEO and GP Dr Laura Edwards talks with a panel around visa sponsorship and how it impacts international graduates particularly around the time of qualification and what actions practices may want to take to help with their recruitment.

Read also the BMA guidance on Visa sponsorship for GP practices