Written Statement: General Medical Services Contract Reform for 2020-21

I am pleased to announce that the negotiations for the 2020-21 General Medical Services (GMS) contract have concluded and agreement reached that will see significant investment into GMS this year, again taking us to a position where our £ per weighted patient value of Global Sum is higher than that of England.

Despite the ongoing impact of Covid-19, we have continued with our ambitious programme of reform to the primary care contracts. The approach is managed through the Primary Care Reform Joint Alignment Group. This group brings together primary care stakeholders from across the sector, setting a clear strategic direction for the reform of all primary care contracts, ensuring alignment to an agreed set of common priorities including access, quality and prevention, working at scale and workforce.

Sitting within that structure, the GMS Contract Group has continued to operate through a tripartite agreement, including representatives from Welsh Government, General Practitioners Committee (GPC) Wales and NHS Wales.  We remain the only UK nation to fully involve the Health Service in work on contract reform and I am again pleased to see the strong alignment and integration that has been seen as a result.

This round of negotiations has been undertaken at a time of significant challenge and I certainly welcome the commitment of all parties to work cooperatively to deliver an agreement which provides additional investment to build on the sustainability of services and importantly recognising the crucial role of all practice staff in the ongoing delivery of GMS.

The new contract further builds on the changes seen in 2019-20, moving further towards delivering on the aims of A Healthier Wales whilst retaining the positive changes seen as part of our response to the Covid-19 pandemic including remote working and improved triage arrangements. In particular, this agreement will see:

• Further strengthening access to and from primary care services including an agreement to work together to enable referrals into GMS from the broader unscheduled care system in order to streamline and simplify the patient journey through that system.

• The removal of the patient charge for completion of a Mental Health and Debt Evidence Form by a healthcare professional, removing a barrier to our most vulnerable groups in accessing the help and advice they need.

• A new phase of Access Standards to be introduced from March 2021, subject to the necessary consultation on the new iteration of standards. Minor amendments will be made to the measures of the existing phase of standards which will remain in place for the remainder of 2020-21.

• The introduction of a new Quality Improvement Project related to planning for urgent care and learning from Covid across clusters with strong links to work already being undertaken at a cluster level.

In recognition of the agreed changes for 2020-21, the following funding arrangements having been reached:

• An uplift of 2.8% to the GP Pay element of the contract for general expenses, fully meeting the DDRB recommendation on pay. 

• Investment of £4.1m to fund a 2.8% uplift to pay for all practice staff, which will be a contractual requirement for this year, in recognition of the vital role practice staff play in the delivery of GMS.

• A further £1.9m award to the general expenses element of the contract, including investment to fully fund the ongoing revenue costs of embedding new ways of working seen as a result of Covid-19.

• A £4.1m investment into Global Sum, through the shift of inactive AF indicators and disease register indicators from QAIF, with disease registers becoming a core function of the GMS contract.

Coupled with the financial changes, activities have been agreed as part of the reformed contract which will build on the existing systems in place for the quality, sharing and availability of data. This includes the creation of a minimum data record supported by a central data and analysis hub and joint working taking forward work in relation to data on GP expenses in order to better understand the impact of future contract changes. 

GMS has played an important role during the pandemic, with all practices being open throughout, responding with agility and innovation to meet the novel requirements of this exceptional situation.  This award demonstrates my appreciation for the efforts of GPs and all staff working in practices for their dedication and commitment during the Covid response. 

I would also like to take this opportunity to thank all colleagues in NHS Wales and GPC Wales for their ongoing engagement and commitment to this programme of reform. I fully recognise the level of commitment shown at a time of such challenge in order to reach this agreement and I am confident that the collaborative effort will continue to stand us in good stead as we move forward.

This statement is being issued during recess in order to keep members informed. Should members wish me to make a further statement or to answer questions on this when the Senedd returns I would be happy to do so.