Changes have been agreed to the General Medical Services GP contract for 2018/19 with effect from 1 April 2018. These changes apply in England only.

Steven Boxwell in our Plymouth office covers the changes.

Although the changes listed below are not comprehensive, they are a selection of the key items to look out for.

The contract for 2018/19 will see an overall increase in funding of 3.4%, or £256m, which will provide a 1% pay increase and a 3% uplift to cover an inflationary rise in practice expenses. This uplift may rise further (backdated to April) once the Government has responded to any recommendations from the Doctors and Dentists Review Body.

Other funding changes include:

  • an investment of £60 million to cover GP indemnity costs for 2017/18
  • an uplift of £22 million to allow a change in the value of a Quality and Outcomes Framework (QOF) point as a result of a Contractor Population Index (CPI) adjustment
  • an uplift to allow an increase to the Item of Service fee for certain vaccination and immunisations (V&I) from £9.80 to £10.06, in line with consumer price index inflation
  • an increase in funding for cover for parental and sickness leave absence. Payment increases by 1% to a maximum of £1751.52 a week. Practices can now also employ salaried GPs on fixed-term contracts to provide cover.
  • a non-recurrent investment of £10 million to recognise additional workload associated with the implementation of e-Referral contractual requirements

Online systems

Practices that do not have at least 10% of their population registered for online services will be ‘contractually obliged’ to work with NHS England to achieve greater use of these services.

From 1 October 2018, GP practices will have to use the NHS e-Referral System for all referrals to first consultant-led outpatient appointments. Guidance on this will be published, but practices will not be penalised if e-RS is not fully implemented in their area.

Also, from October 2018, phase 4 of the electronic prescription service (EPS) will be implemented. A patient awareness campaign, including resources to help practices address patients’ concerns, will be undertaken.

Other key changes

  • NHS England and the GPC have agreed changes to the 2013 Premises Cost Directions, though a six-month review of premises will start in summer 2018 led by NHS England and the DHSC.
  • NHS England and the GPC will work together to support further use of direct booking of GP appointments by NHS 111, where agreed with practices.
  • Practices must not advertise private providers of GP services which the practice should be providing free of charge. Contractual enforcement may be necessary in next year’s contract.
  • The GPC will encourage practices to make use of the NHS diabetes prevention programme.
  • NHS England, NHS Digital and the GPC will collaborate on assessing data to help better understand workload pressures in general practice.
  • New freedom to speak up guidance and systems will be introduced in general practice no later than 1 April 2019.

Future developments

Looking to the future, there will be discussions taking place about introducing an unweighted element of the funding formula to reflect practice costs that are not linked to the features of their practice population.

The GPC says it is currently engaged in a ‘wholesale review of the QOF’, a review into how to reinvigorate the partnership model and further workforce initiatives.

If you would like to discuss any of these issues, please contact a member of our specialist Doctors team.


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