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GP contract: Practices at risk of closure unless 1.9% offer is improved, warns BMA

BMJ 2024; 384 doi: https://doi.org/10.1136/bmj.q287 (Published 02 February 2024) Cite this as: BMJ 2024;384:q287
  1. Gareth Iacobucci
  1. The BMJ

Many general practices will be at risk of closing down or face “awful choices” over staff redundancies and the services they provide unless the government improves its contractual offer to the profession, the BMA’s General Practitioners Committee for England has warned.

The committee said the offer of a 1.9% uplift to core general medical services (GMS) funding provided nowhere near what is needed to prevent practices from reducing services or closing down altogether. The 2024-25 offer will do little to bring hope, stability, or safety to the profession and will worsen patients’ access even further, it added.

At a meeting on Thursday 1 February the committee unanimously instructed its leadership team to continue talks with the government and NHS England over the next few weeks to deal with its concerns. The committee intends to put the final contract offer to a referendum vote of members on 1 March.

Details of the offer come at a time when a BMA survey of 10% of practices in England found that almost two thirds (375 of 588, 64%) reported concerns over short and long term viability. More than half (323 of 567, 57%) have experienced cashflow problems in the past 12 months.

Even before the offer, up to a quarter of practices were seriously considering reducing their staffing to remain open for patients, the BMA estimated.

Katie Bramall-Stainer, chair of GPC England, said she had met with the health minister Andrea Leadsom on Wednesday 31 January and was hopeful that further talks could yield progress.

Bramall-Stainer said, “The current offer means that practices will not be able to break even and will face awful choices over staff redundancies and service delivery, which is incredibly concerning for GPs and patients in England. It is unconscionable that we are even seeing GPs out of work and practices laying off staff to keep their doors open.

“We know a significant majority of practices are struggling. Costs have risen, driven by soaring inflation; 1.9% may be what was set by Treasury in their operational planning guidance back in 2021, but such slavish adherence to budget lines from three years ago is not replicated elsewhere in the NHS. This regrettably falls far below what we realistically need to keep our heads above water and what GPC England has reasonably called for.”

Bramall-Strainer said the committee had presented the government and NHS England with “evidence and data” that made the “unarguable economic case for investment in GP services.”

She said, “To ignore it risks saving pennies today in order to spend pounds tomorrow. It risks a swathe of practices facing no choice but to hand their contracts back, fuelling unemployment for trained GPs willing and able to work, and for some practices to close for good. That would be a ridiculous waste of taxpayers’ money and puts the care of the million plus patients we see each and every day at risk.”