- Posted Monday March 6, 2017
With NHS budgets remaining as tight as they've ever been, the details of the newly announced changes to the GP contract for 2017-18 have been eagerly awaited by everyone in primary care.
As ever with this sort of announcement, there's good news and bad news to share. How your particular practice will be impacted by the changes will very much depend on both its individual circumstances and how the changes actually work in practice.
It's safe to say that the decision to directly reimburse practices for their CQC registration fees in order to allow them to concentrate available resources elsewhere will be seen as a positive move by everyone. The same is true of the £30m of funding being provided to help cover the rise in indemnity fees that have been seen in recent years, as well as the planned improvements to the current sickness and maternity absence arrangements.
An additional £6m to expand the flu vaccination programme to include the morbidly obese and increased funding for the Learning Disability enhanced service will also be welcomed. From a bureaucracy point of view, the decision to delay the planned QOF review and hold off on making any changes to the existing regime will doubtless leave PMs breathing a sigh of relief.
More clarity is required on what the final overall funding uplift figure will be for 2017/18 to see how it will impact on increasing practice expenses. It’s also worth nothing that while a one per cent pay increase is of course positive news for GPs, it does need to be set in the context of inflation being expected to rise by proportionally much more than that during the period in question.
Perhaps the area that will raise most interest will be the move to end the Unplanned Admissions direct enhanced service (DES) in the name of reducing the bureaucratic burden that it places on practices. It will be replaced by a requirement for GPs to create a risk register of their severely frail older patients, which will be monitored through regular reviews.
Any reduction in the amount of practice time being tied up by unnecessary paperwork will be viewed positively, as will the renewed emphasis on this growing cohort of patients receiving appropriate care. However, the actual resources that setting up and managing this register will require, and the wider impact it will have on other practice operations, remains to be seen.
Additionally, the fact that the £156.7m that was allocated to the Unplanned Admissions DES will be moved into the Global Sum could see some high-performing practices lose out financially.
NHS England does appear to have taken GPs’ concerns into account in a range of areas, but as ever, when any changes come in, we'll only see what they really mean when they actually go live.
Practice managers will need to keep a close eye on the impact on personnel, services and systems, and be prepared to take proactive action as issues come to light in order to prevent any real problems arising.
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