General practice nurses are in line for a pay boost as part of a new “radical” contract for primary care across England, though it is likely it will be up to individual practices to decide how much money to pass on to their employees.
The fresh funding package agreed between NHS England and the British Medical Association doctors’ union today gives practices almost £1bn over the next five years.
“It is the biggest reform of general practice in over a decade”
The deal, part of the NHS Long Term Plan, will mean every practice can increase the pay of all their staff, including nurses, by at least 2% in the first year, according to the BMA. The contract also allows for further wage rises in the subsequent four years to meet inflation.
An additional £1.8bn will be invested to support the formation of primary care networks, in which groups of practices will club together to provide care to patients across a wider geographic area. Each network will be led by a single GP.
The money will be used to expand the workforce by more 20,000 people to include physician associates, physiotherapists and paramedics, clinical pharmacists and social prescribing link workers. It is hoped the new additions to the team will help relieve pressure on busy doctors and nurses and allow patients to see the right professional first time.
The BMA stated there would be a “guaranteed investment” of £405m through the practice contract and network contract in the first year of the deal, meaning “every practice will be able to uplift staff pay by at least 2%”.
Unison head of health Sara Gorton said it was ”vital to ensure pay and conditions for staff in general practice are in line with the rest of the NHS”.
Source: Department of Health and Social Care
The NHS Long Term Plan included a promise to bring “digital-enabled care into the mainstream”. As part of this five-year contract, practices will make 25% of appointments bookable online.
Patients will be able to order repeat prescriptions electronically from April 2019 and have digital access to their full records from 2020.
By 2021, they will have the right to “digital first primary care”, including web and video consultations.
The contract requires practices to make one appointment available a day for every 3,000 patients on their list to be directly booked through the NHS 111 non-emergency phone line.
The GP quality outcomes framework (QOF) will be overhauled, replacing unnecessary indicators with “professionally-led quality improvement”.
The reform of the QOF will see changes in the management of conditions such as diabetes, blood pressure, cervical screening, heart failure, asthma, COPD, and mental health.
The contract also delivers the much-awaited state-backed indemnity scheme for staff, meaning they will no longer have to personally fund clinical negligence cover.
Supporters say the contract makes good on the commitment in the NHS Long Term Plan to move into the community and put a greater focus on illness prevention and earlier intervention.
NHS England boss Simon Stevens said the five-year deal “unarguably” represented the biggest boost to primary care in more than 15 years.
Dr Richard Vautrey, BMA GP committee chair, said the group was confident the changes promised through the contract would deliver the best for both GPs and patients across England.
“Recent years have seen hard-working family doctors deal with an overstretched workforce doing their best to meet rising demand from patients suffering more and more complex conditions, all on the back of a decade of underinvestment in general practice,” he said.
“Therefore, we are pleased after months of discussions with NHS England, to have negotiated a package of reforms to the GP contract and beyond, that will begin addressing the unsustainable situation,” he added.
Prime minister Theresa May said the contract meant GP staff could “plan for the future with confidence”.
Health and social care secretary Matt Hancock added that the deal provided “certainty and security” for all those working in general practice, and more modern access for patients.
Source: Neil O’Connor
Niall Dickson, chief executive of the NHS Confederation, which represents organisations across the healthcare sector, said: “This investment in primary care and the creation of networks with different health and care staff working together for the benefit of patients is a fantastic opportunity to support overstretched general practice as well as other hard-pressed services in the community.
“This builds on the considerable work over recent years to develop more integrated primary and community services,” he said. ”It is the right approach but we have needed this increased investment and focus to have a chance of making it a reality throughout the country.”
Nigel Edwards, chief executive of independent think-tank Nuffield Trust, said the new contract was a “radical step” and likely to lead to a “historic move” away from GP surgeries as freestanding small businesses.
Richard Murray, chief executive of the King’s Fund, another key health think-tank, said: “The contract is a promising early sign that the government and NHS England are making good on the commitments in the NHS long-term plan to shift resources to primary and community care.
“It is the biggest reform of general practice in over a decade and could bring significant benefits to patients,” he said.
He added that the deal was a “welcome recognition” the pressures facing general practice and signalled a “fundamental change” in the way that GP services will be delivered thanks to the widening of the workforce.
However, Mr Murray said the timetable for the changes looked “extremely challenging” and warned that services would need support to bring the plans to fruition.
In total, an extra £4.5bn is set to be invested into primary medical and community care by 2023 under the new long-term plan – the first time the budget for these services will increase as a share of the NHS budget for the first time in its 70-year history.