Written Statement: General Medical Services (GMS) Contract Reform for 2022-23 onwards

I am pleased to announce that negotiations for the 2022-23 General Medical Services (GMS) contract have concluded, and agreement reached that will see transformational changes to the contract to reduce complexity and bureaucracy, focussing on those services which every GP practice in Wales can and should deliver.  At the same time, the changes I am announcing today will continue to improve access to and from services and place a greater focus on quality of care, with clinical judgment and patient need at the heart of service delivery.

Throughout the last year and the challenges that the system has continued to face, we have continued with our ambitious programme of reform for all four primary care contracted professions, including GMS. This year has seen an especially wide-reaching mandate for change which will span not only this year, but years to come in terms of the improvements being delivered.

Staff from across the sector have continued to work tirelessly in the face of ongoing pressure, to meet the needs of their patients. They have remained agile and responsive to the changing public health situation and remained open and available to those who need them the most. However, there has continued to be challenges faced by some people in accessing their GP practice which need to be resolved.

As we move forward, a new simplified and streamlined contract will not only remove unnecessary bureaucracy for GPs and their teams but will also reinforce the standards by which we expect GP practices to operate – with patient access an integral part of those standards.

This agreement sees new investment of over £17m and contract changes which will improve services for patients, whilst once again recognising the vital role GPs and all staff working in general practice play in the ongoing delivery of GMS.

The package of changes agreed for this year and into the forthcoming financial years, takes on board the key learning throughout the pandemic and is a significant step forward in delivering our Programme for Government commitments and the vision of A Healthier Wales. In particular, this agreement will see:

• A proposed new GMS contract which is simplified and streamlined to focus on those services which can and should be delivered by every GP practice in Wales. The approach seeks to remove unnecessary bureaucracy in current arrangements and focusses on clinical judgement and patient need to address the current gaps in service delivery.

• Minimum access standards embedded into the contract and mandated for all GP practices in Wales. This will ensure that all practices fully implement and comply with those standards initially introduced in 2019 whilst securing continuing improvement over the coming year.

• Strengthened quality assurance through the contract and the proposed introduction of a robust and proportionate assurance framework. Coupled with the improved quality and sharing of data in relation to GMS appointments, this will significantly improve the understanding of the breadth of activity underway in GMS.

• The Quality Assurance and Improvement Framework will be overhauled to provide a clear focus on Quality Improvement, with those other elements of the framework moving into the contract and therefore mandated for all practices.

• A number of Heads of Terms commitments which will see joint working between all parties and key stakeholders to further advance change in several key areas including workforce sustainability, digital access and data, and prevention.

I am grateful for the role GPs and their teams have played – and continue to play – in the delivery of crucial services for people in Wales. Given that, and the comprehensive and ambitious package of agreed changes, the following funding arrangements have also been agreed:

• An uplift of 4.5% to the GP pay element of the contract, fully meeting the DDRB recommendation on pay.

• An additional £7.5m investment to fund a commensurate 4.5% pay uplift for all staff working within general practice. This will again be a contractual requirement for this year and will see all existing staff working in GMS receiving a 4.5% uplift to their gross pay.

• A further £2.7m award to support practices with ongoing business expenses.

Coupled with this new investment, the changes sought through the transformation of QAIF and the proposed new contract, will also see a significant shift of existing funds into global sum, which will bring certainty to practices during a time of financial challenge.

Wider commitments to explore workforce initiatives, sustainability and service improvement, and the digital agenda will ensure GMS continues to pursue positive change and reform.

GMS is an integral part of the healthcare system in Wales and is pivotal to the whole system’s recovery and transformation. This agreement demonstrates not only my appreciation for their efforts but also their commitment to pursuing positive changes for the profession and the public alike.

I would like to take this opportunity to thank all colleagues in GPC Wales and NHS Wales for their engagement and commitment to this programme of reform, including the development of the proposed new contract from 2023. The positive relationships we have here in Wales have seen us make a huge amount of progress and will support us as we move to formally consult on the proposed new contract. This year has been another challenging one, and I do not underestimate the efforts all have put into reaching this agreement.