Pulse February 2019 issue - Page 7

A more realistic approach? But there are also positive signs suggesting that, unlike his predecessor, he does not wish to pick a fight with GPs. He accepts the deadline for increasing GP recruitment is unachievable, acknowledges the problems with ‘last man standing’, and – most surprisingly – reveals he is in discussions with the Chancellor to reform the pensions tax rules that drive many GPs to early retirement. But there’s no doubt the main focus is on the long-term plan and the funding uplift. And the £4.5bn is a significant investment – totaling 21% of the £20.5bn annual increase in NHS funding by 2023/24 – and includes a bonus £1bn on top of the £3.5bn announced by Theresa May in December last year. Much of this funding is earmarked to support the rollout of ‘primary care networks’ – large groups of practices covering 30,000-50,000 patients each. This will even form part of the 2019/20 GP contract, trailed as the ‘biggest GP contract reform since 2004’. Until its release – expected early this month – we don’t know exactly how this will work, and there are real concerns for those Matt Hancock on... GP recruitment targets The target of 5,000 more GPs than the 2015 fi gure exists and we’re going to meet it. Clearly the timing of that will be slower than originally envisaged before my time… we haven’t put a date on it. GP pensions The biggest concern I hear from GPs is about the tax treatment of pensions… I’ve had conversations with the Chancellor about looking at this because I understand the impact that it has. Funding the indemnity scheme from the global fund Those costs have to fall somewhere. Our goal is to stop the rise in those costs and I very much hope that we can support GPs in making sure the system works better in the future. The use of other healthcare professionals There are lots of things that can be delivered by other health professionals that GPs currently do, freeing up GPs to do those things, to make the interventions that their full training is needed for. GPs tell me this all the time. Patient demand I know the pressures of society and the pressures of expectations from patients: ‘I’m here for a drug and I’m not leaving until you prescribe me something...’ The £350m a week ‘Brexit dividend’ The £20.5bn long-term plan funding is guaranteed in all Brexit scenarios. ONLINE For a full transcript of this interview, visit pulsetoday.co.uk/ hancock practices that, due to geography, or other local factors, are struggling to join a network. Indeed, even those that are part of a larger organisation worry they might not be classed as a ‘network’ when the contract comes to define it. For all GPs, though, there is a more pressing matter – will they receive any of the funding now to relieve the huge pressure on practice? ‘Absolutely,’ Mr Hancock exclaims. ‘I get the fact that there is too much pressure on primary care and on GPs. Some of the money is specifically aimed at relieving that pressure and ensuring that it’s easier for a patient to see their GP and trying to take some of the pressure out of that system.’ GPs could be forgiven for their cynicism. They’ve been here before, with funding inevitably tied to providing extra services and uplifts to the global sum nowhere near what is required. And there are indications that this might again be the case this year. The BMA’s GP Committee and NHS England are in dispute over whether the new state- backed indemnity scheme will be funded from the global sum. If the Government does raid the global sum to fund the scheme, could it claim to be serious about easing the pressure on GPs? On this Mr Hancock provides little ► Pulse February 2019 F   ew GPs would have heard of Matt Hancock before July of last year. Our only clue about how he sees general practice has been his Tigger-like enthusiasm to accelerate its use of technology. This is the man, don’t forget, who launched an eponymous app. So when Pulse speaks to him just days after the publication of the NHS’s 10-year strategy – his first interview with the trade press since then – it feels significant. Because his tenure is likely to define general practice for decades to come. Mr Hancock is a ball of energy. There is a cricket bat nearby, which he is known to use for impromptu net sessions in the office. He seems characteristically upbeat – not surprising given the reaction to the plan, which knocked Brexit off the front pages for a few days. And primary care is central to the plan. ‘GPs are the bedrock of the NHS and the long-term plan is predicated on reducing demand for expensive hospital treatments by having more support for people in the community and trying to keep people healthy in the first place,’ Mr Hancock says. ‘Hence the £4.5bn for community and primary care – this is the biggest uplift in the plan.’ The interview throws up good and bad signs. GPs may be wary of the idea that other healthcare professionals will solve the workload crisis, and will be angry at hints that the state-funded indemnity scheme will be paid out of the global sum. Mr Hancock’s heavy focus on technology may also be a source of frustration; he is unrepentant about his positive comments on private company Babylon that infuriated many GPs. 7