Changes to GMS contract for GPs for 2018/19

26th March, 2018

The announcement on 20 March of an increased investment of 3.4% in funds for GMS practices in England is to be welcomed. However, for practice managers and GP partners wondering what this means for their practice, some delving into the detail of the announcement is required.

Firstly, it is important to note that 0.8% of the investment is to allow for the predicted increase in the population, therefore a practice with a static list size might reasonably expect an increase of not 3.4%, but 2.6%

Whether or not a practice will see an increase of this size will depend on their individual characteristics, and the sources from which their income is derived as different increases are being applied to different sources. An example of this is given below.

The announcement relates to the income being paid to practices. Out of this they will have to fund increases in expenses. Significantly the NHS pay deal agreed by union leaders and ministers on 21 March is likely to lead to increases in staff salaries particularly at the lower end of the pay scales. Whilst most practices are not contractually bound by the Agenda for Change pay rates, they are in many cases competing with secondary care to attract staff.

There may be further uplift in funding once the Review Body on Doctors’ and Dentists’ remuneration has reported in May 2018. It is to be hoped that the difficulties in recruiting and retaining GPs will be recognised in their report.

Example practice with a list size of 10,000 and a weighted list size of 9,500

2017/18 2018/19
£ £ Increase
Global sum 770,925 794,580 3.1%
GP Indemnity Support 5,160 10,170 97.1%
QOF (say 530 points scored) 117,351 117,352 0.0%
Enhanced services (say £15 per patient) 150,000 151,500 1.0%
1,043,436 1,073,602 2.9%
MPIG 19,200 14,400 -25.0%
Seniority 9,300 6,200 -33.3%
1,071,936 1,094,202 2.1%
  • Global sum – after deducting the Out of Hours adjustment the global sum per weighted patient is increasing from £81.15 to £83.64.
  • The GP indemnity support payment is increasing from 51.6p to 101.7p per raw patient. Strictly speaking the 101.7p, which is being paid in March 2018, relates to the 2017/18 year but as the increase has been included in the announcement about the investment in 2018/19, it has been included in the later year.
  • The value of each QOF point has been increased by 4.7%, but so has the average list size so a practice with a static list size will see no change in income.
  • Very difficult to generalise, but item of service fees for certain vaccinations and immunisations are being increased by 2.7% so have assumed an increase of 1% overall.
  • MPIG will vary greatly from practice to practice. 2018/19 is the 5th year out of 7 over which the MPIG is being phased out.
  • Seniority again will vary greatly from practice to practice, but is being phased out by March 2020.

If you would like further guidance on how this announcement may impact your practice, please get in contact with myself or my colleague Mike Woodford, specialists in Healthcare and Medical Accounting and Advice.

Telephone: 01872 276477

mike.woodford@pkf-francisclark.co.uk 

luke.bennett@pkf-francisclark.co.uk

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