All you need to know 4 1 GP contract likely to mandate practices to join networks GP practices in England are expected to have to join primary care networks, serving 30,000-50,000 patients, under the new GP contract that will take effect from April. Last month’s NHS long-term plan confirmed an extra £4.5bn a year will be given to primary and community care by 2023/24 to fund ‘expanded community multidisciplinary teams aligned with new primary care networks’. The BMA’s GP Committee, which is negotiating the 2019/20 GP contract changes, said practices would be required to join the networks but would not need to give up their GMS contract. Committee chair Dr Richard Vautrey said it would be ‘beneficial’ for practices to ‘work with colleagues across an area’. • The long-term plan at a glance, page 10 2 Hancock in talks with Treasury about GP pension tax rules The health secretary is in discussions over changing the tax treatment of pensions due to its adverse effect on GP retention, he has told Pulse in an exclusive interview. Matt Hancock revealed that tax charges on pensions are ‘the biggest concern raised with me’ by GPs. The lifetime allowance for pensions tax relief was brought down from £1.25m to £1m in 2016, which hits GPs disproportionately hard and leaves them with little incentive to stay in practice until retirement age. Mr Hancock said he had had ‘conversations with the Chancellor’ and ‘understood the impact’ of the rules. • Big Interview, page 6 Pulse February 2019 The big question 3 Partners should have structures to limit liability, says review The Government should carry out a ‘rapid piece of work’ to determine new legal structures for GP partners holding GMS and PMS contracts to mitigate their risk of unlimited liability, the review of the partnership model has recommended. The review’s final report also proposed that NHS England make it easier for GPs to hand back their contracts without being liable for outstanding lease payments. Review chair Dr Nigel Watson said GPs in some areas are cutting surgery hours to work for extended access services, due to the attractive pay and less onerous workload. • For Pulse’s full coverage of the review visit tinyurl.com/partnership-review 4 GPs can now order a single fl u vaccine for ages nine and over NHS England has announced that a new flu vaccine is to be licensed by the Joint Committee on Vaccination and Immunisation for use in all patients aged nine years and over. For the next flu season, GPs can choose between the new QIVc vaccine or the currently available aTIV and QIVe. The new vaccine will be supplied by Seqirus, whose phased delivery of the aTIV vaccine for the current flu season saw almost 70% of GPs experience a shortage, forcing them to turn away vulnerable older patients. 5 Five-year GP-based training could start in 2021 A five-year GP-based training scheme could start in 2021 as part of a pilot project in east London, NHS England’s new care models adviser has said. GP Sir Sam Everington, who also chairs Tower Hamlets CCG, said the trial will see students enter GP training straight out of medical school, rather than going into the current two-year hospital-based foundation programme before entering GP speciality training. Will practices foot the bill for the GP indemnity scheme? In 2017 the Government promised GPs a state-backed indemnity scheme to address the soaring costs of medical negligence cover. But ministers have since suggested the scheme – due to start in April – could be funded through ‘existing resources’. Asked in an interview with Pulse whether the scheme would be funded from the global sum, health secretary Matt Hancock said: ‘The costs have to fall somewhere... it is tied to the negotiations around the GP contract.’ But Dr Nigel Watson, chair of the GP partnership review, published last month, warned that if the ‘whole cost’ was covered by core GMS funding ‘it would be a disaster as all partners would take a pay cut’. The BMA GP Committee and NHS England have reached stalemate on the issue. GPs will have to wait until later this month to fi nd out where the costs will eventually fall. Your comments • ‘You wonder why GPs do not trust the Government. They have increased our risks so much and caused the rising costs and now this!’ • ‘So I won’t be paying for it by paying for it.’ #GPnews what’s hot online Snap generalisation Just as ministers want patients to bypass GPs and self-refer, so GPs are bypassing the Government and finding ways to keep GP recruitment out of the emergency room. Dr Dornu Lebari tweeted that she had ‘managed to convince another unsuspecting junior doctor’ that indecision over choice of specialty was a symptom of a desire to be a GP. Not everyone thinks Dr Lebari has a future in careers advice though. ‘You must really hate [junior doctors],’ lamented one respondent. Nothing to see here While the trials of the festive break are now safely in the past, Dr Zoe Norris’ ‘short- term plan’ (see page 46) implores NHS England to let practices close early on Christmas Eve this year.