The 2018/19 contract will see funding for practices in England increase by £256.3m, which will cover:
- An initial 1% pay uplift and inflationary uplift to expenses of 3%, which is expected to be increased further when the Doctors and Dentists Review Body makes its recommendation on pay later this year. Any increase will be backdated to 1 April. NHS Employers said it expects the DDRB recommendations to be available in May 2018.
- Taking into acccount the pay and expenses uplift, recycling of MPIG and seniority funding the global sum will rise from £85.35 per weighted patient to £87.92.
- £60m to cover rising indemnity costs. This will be distributed to practices directly in the same way as last year and works out as £1.017 per registered patient.
- An uplift to item of service fees for certain vaccinations from £9.80 to £10.06. Full detail of immunisation changes can be found here.
- £22m to cover the change in value of a QOF point. The value of a QOF point will increase from £171.20 to £179.26.
- Improvements in funding for sickness and maternity/parental/adoption leave cover. Reimbursement will also be simplifed so that if a practice chooses to employ a salaried GP on a fixed-term contract to provide cover, NHS England will reimburse the cost at the same level as cover provided by a locum or a salaried GP or partner already employed by the practice. Details of the changes are here.
- £10m of non-recurrent funding to cover the work associated with rolling out full use of the e-referral system (see below). Practices will receive 17p per weighted patient for this in 2018/19 only.
The following has also been agreed:
- From October 2018 it will be a contractual requirement for practices to use the e-referral system (eRS) for all referrals to first consultant-led outpatient appointments. It is for the practice to determine how they do this and it could be the administrative team making the referrals on the system, not the GP. There will be £10m of non-recurrent funding to cover the work associated with this. Read more here.
- Changes to premises cost directions to enable further investment in GP premises, and clarification on issues related to last person standing. Full details of the changes here.
- Strengthened violent patient regulations. More detail here.
- Practices that do not have at least 10% of their population registered for online services will be contractually required to work with NHS England to boost uptake of these services.
- Over the next year NHS England and the GPC will work together to support further use of direct booking of GP appointments by NHS 111, where agreed by practices, to evaluate the benefits. This will inform the 2019/20 contract negotiations.
Changes to QOF
QOF indicators continue unchanged, except minor changes to clinical codes for the learning disabilities register. The indicator has therefore changed from LD003 to LD004. A summary of the indicators for 2018/19 can be downloaded here.
A series of non-contractual changes have also been agreed. These aim to set out areas of joint work between the GPC and NHS England and are not contractual requirements for practices. However the BMA encourages practices to take note of these and 'action when appropriate'.
- A number of pilots will move to stage 4 of the EPS roll-out. This will only involve practices who agree to the pilots.
- The BMA will encourage the development and use of social prescribing.
- Practices should not advertise private GP services where that service should be provided free of charge. The GPC and NHS England will work with CCGs and LMCs to ensure this does not happen. If necessary this will be reinforcd by a contractual clarification for 2019/20.
- The BMA will encourage uptake of the Diabetes Prevention Programme.
- NHS England, the GPC and DHSC will work together to improve data on locum usage by undertaking a survey with a sample of practices.
- The BMA has agreed to discuss new out of hours key performance indicators, which will replace the national quality requirements later this year.
More on the contract
- Vaccination and immunisation changes
- Payments for parental and sick leave
- How have the premises cost directions changed?
- Changes to violent patient regulations
- What are practices' contractual obligations on e-referrals?