The new GP contract includes several changes to vaccination and immunisation programmes, as well as an increase in investment.
The contract for 2018/19, agreed by NHS Employers and the general practitioners committee (GPC) of the British Medical Association (BMA), offers an overall funding increase of £256m.
The contract will see GPs getting a 1% pay rise and a 3% uplift in expenses.
Practices will also receive a once-off £60m payment to cover the increased costs of indemnity last year, which will be paid this month.
The contract announced the following amendments to vaccinations and immunisations programmes from April this year:
- The three month dose of pneumococcal has been removed from the targeted childhood immunisations scheme, based on the recommendation from the JCVI. The funding for this element of the childhood immunisation will be unaffected.
- Hepatitis B (newborn babies) programme has been renamed as the Hepatitis B at-risk (newborn babies) programme and the number of recommended doses has been reduced to three.
- The meningococcal ACWY 18 years on 31 August programme has been removed and the meningococcal ACWY completing dose date of eligibility has changed from 1 April 2015 to 1 April 2012, meaning all patients within the age range are now eligible. Practices are not required to proactively offer or encourage patients to be vaccinated. Vaccination of 14-16 years is only where the patient has missed schools provision.
- Meningococcal B – there are no changes to the vaccinations programme, but the requirements are now defined in the statement of financial entitlements (SFE) rather than in a service specification.
The following programmess will be unaffected: pneumococcal (PCV – remaining at £15.02), childhood seasonal influenza, pertussis, seasonal influenza and pneumococcal polysaccharide.
In order to ‘ensure all real expenses are covered’, vaccinations and immunisations that are reimbursed through the SFE will be uplifted by the contractor population index (CPI). The item of service fee for these immunisations will be uplifted by 26p from £9.80 to £10.06.
The investment includes the hepatitis B at-risk immunisation for newborn babies, HPV completing dose, meningococcal ACWY freshers, meningococcal B, meningococcal completing dose, MMR, rotavirus, and the shingles routine and shingles catch-up vaccines.
The contract added that ‘it is our intention to secure a similar inflationary increase for other immunisations as soon as possible’.
The Quality and Outcomes Framework (QOF)
There will be no changes to QOF indicators for the coming year, while the national QOF review is ongoing.
However, the CPI will be adjusted to reflect the changes in list size and population growth, and the value of a QOF point will be increase from £171.20 to £179.26 to account for this.
The contract also promises a major six-month review of primary care premises to make sure they are ‘fit for purpose’.
The GPC said: ‘We have been very clear that there needs to be a more fundamental review of GP premises, as in many areas in the country it is premises problems that are leading practices to hand back their contract.’
Under changes to the regulations, practices will also be able to remove ‘violent’ patients who were registered with them after being removed from another surgery’s list for violent behaviour.
The BMA said the regulations for refusing registration, if there are reasonable grounds, are being tightened up.
They said: ‘We are further strengthening these regulations to allow a practice to remove a patient who has joined them from a previous practice who removed them because of a violent incident and placed a violent patient flag on their record.’
Any violent patients who are removed will be put onto the appropriate ‘special allocation scheme’ unless they refuse.