Written Statement: General Medical Services (GMS) Contract Reform for 2021-22

I am pleased to announce that negotiations for the 2021-22 General Medical Services (GMS) contract have concluded and an agreement reached that will see investment into GMS that improves access to services whilst also supporting additional capacity in the system. This additional capacity will be of particular importance given the increasing winter pressures that the whole health system is currently experiencing.

Throughout the pandemic and the challenges that this has brought, we have continued with our ambitious programme of reform for all four primary care contracts, including GMS.  The overarching programme of work continues to be managed through the Primary Care Joint Alignment Group and the strong tripartite approach, which brings Welsh Government, NHS Wales and our stakeholders together has been of significant value throughout the course of these contract negotiations.

I recognise that staff from across the sector have worked hard, often in the face of immense challenge and pressure, over the course of the pandemic. They have remained open to patients who need them and have responded with agility, adapting to new ways of working, whilst prioritising those most in need. I’m also very aware that the system hasn’t worked as well as it could for everyone and in some instances, people have found access to their GP practice difficult. This agreement will provide additional investment and contract changes that aims to improve services for patients whilst also, once again, recognising the vital role all practice staff play in the ongoing delivery of GMS.

The new 2021-22 contract builds on the learning from Covid-19 and takes us a step closer to fully delivering the aims of A Healthier Wales. In particular, this agreement will see:

• Improving access to and from primary care services by removing the existing ‘8am bottleneck’ that exists and ensuring that patient need is met at the first point of contact.

• A Winter Capacity Fund of £2m for the remainder of this financial year will support practices to increase their staffing capacity to meet the winter challenges ahead.

• From 1 April 2022, the Capacity Fund will increase to £4m, running recurrently for three years and will support the full implementation of the Access Commitment.

• Joint working between officials, NHS Wales and GPC Wales, with other key stakeholders will further strengthen the important role GMS already play in prevention. Specifically, this agreement will focus on obesity and pre-diabetes given the clear link to longer term chronic conditions and the opportunities for early intervention.

• The Quality Assurance and Improvement Framework (QAIF) will be revised and re-focussed, taking into account the learning gained since its introduction in 2019 and the progress on cluster development.

• Two new Quality Improvement (QI) projects relating to GMS data will be introduced this year to improve the quality of current activity data whilst standardising clinical data entry.

In recognition of this comprehensive and ambitious package of agreed changes, the following funding arrangements having been reached:

• An uplift of 3% to the GP Pay element of the contract, fully meeting the DDRB recommendation on pay.

• Investment of £4.8m to fund a 3% uplift to pay for all practice staff. This will a be contractual requirement for this year, and will see all existing GMS staff receiving a 3% uplift to their gross pay, in recognition of the vital role they play in the delivery of GMS.

• A further £2m award to support additional capacity within GMS over the coming winter, increasing to £4m from 1 April 2022, recurrently for three years.

Coupled with the financial changes, wider arrangements in relation to partner incentives and workforce support will ensure that GMS continues to be an attractive place to work here in Wales.

GMS has played an important role during the pandemic and will continue to do so as the whole system looks to respond and recover. This agreement demonstrates my appreciation for the efforts of GPs and all staff working in GP practices for their dedication and commitment during the last 18 months.

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 do not underestimate the level of commitment and collaborative working shown in order to reach this agreement and I am confident that those efforts will continue to support us as we move forward.