Updated GP contract – AISMA verdict: PCNs win but core contract loses out

Response to update to the GP contract agreement 2020/21 – 2023/24
Published by the BMA on 6 February 2020

Speaking on behalf of the Association of Independent Specialist Medical Accountants, Andrew Pow, partner at Mazars UK, said: “It is positive that NHS England has responded to the concerns raised around PCNs, particularly the removal of the requirement for practices to fund 30% of the cost of new roles and the assurances given around the risk of future employment liability. It is encouraging that PCNs can now actively chose to engage with community partners to employ staff on their behalf.

“There is now a clear active agenda to encourage resources to flow into primary care, although concerns remain around the availability of staff to take up new roles, particularly in areas that have struggled to recruit.”

Mr Pow continued: “It is encouraging to see financial support for new doctors taking up partnerships, although the new contract does not address the current retention issue. From April 2020 seniority income will cease and it is disappointing that there is no replacement of incentives for partners to remain as partners. Many partners will question the Locum Support Scheme as they already feel the balance in favour of being a locum over a partner is too strong.”

According to Mr Pow, the digital-first service initiative is positive, with many areas now adopting these services to improve patient access. “It is not entirely clear what funding will attach to this, but if it is funded in a similar way to PCN staff then it should be helpful”, he said.

While there is good news around premises investment, Mr Pow said issues remain about premises costs in leased premises which remain unresolved.

Mr Pow warned that, against a backdrop of constructive initiatives and support, there is very little additional funding going into the core GMS/PMS contracts, which will be expected to pick up the costs involved with improved employment provisions for staff. “Many practices are now beginning to feel the impact of the increases in the minimum wage flowing through all staff levels”, he said. “A rise in the global sum to £93.46 – an increase of £3.58 on the face of it – looks positive. However, practices will have lost all MPIG and seniority funding from April 2020 and have staff pay increases and new employment conditions to absorb. In many cases this may deliver a profit reduction year-on-year.”