Deal to end dispute over funding restoration accepted by BMA Scotland GP committee

Dear All,

We are delighted to announce that the BMA’s Scottish GP Committee has voted to accept a deal we negotiated with the Scottish Government to end our formal dispute over funding restoration.

The terms of the deal mean that over the next three financial years, the Scottish Government has committed to invest directly in General Practice with close to an additional £250 million annually recurring by year three. The bulk of this, £148.3 million, will be to stabilise and improve our workforce to cope with the huge pressures we all face.

There is also money to cover non-staff expenses, enhancements to the SFE to support locum cover, additional funding for quality, digital improvements and to address health inequalities. As we have been clear throughout, this investment is not related to pay, it is about investing in general practice and bringing stability and security to the service we know has suffered significant losses and absorbed so much pressure in recent years. The full details are in the offer letter below.

While your BMA negotiating team have robustly represented the profession, we have also been able to work collaboratively and constructively on this deal with Scottish Government ever since we entered formal dispute in June. Now that agreement has been reached, for the first time in some years, we have a sense of genuine optimism for the future of our great profession. This investment fulfils our key ask of funding being put directly into general practice, supporting our autonomy and the integrity of the independent contractor model. This is a vital shift from the Scottish Government and comes on the back of policy developed by GPs from across the country and formalised at the Scottish LMC conference. Importantly, we are clear it is very much to restore and sustain General Practice. It provides a platform by which we can lay the groundwork for a brighter future. In our view, it is a vital plank for supporting the delivery of the Scottish Government’s Service Renewal Framework and Population Health Framework over the coming decade. It is far from the end of the story though, we know there is still much more to do to get to the appropriate share of the Scottish health budget being spent directly in General Practice, the most fiscally disciplined and cost-effective part of the NHS.

In terms of the specifics of the deal, we have further work to do as a negotiating team to reach agreement with Scottish Government on  some of the detail but we want to assure you that the talks remain collaborative, supported by a clear terms of reference, to ensure that any asks of GPs within the deal are fair and reasonable.

The following table details how the money will be made available over the following three financial years. This is on a recurrent basis.

Priority	25/26 (£m)	26/27 (£m)	27/28 (£m) Additional	28/29 (£m) Additional	Total recurring (£m)
Workforce		35	31.6	51.7	118.3
Workforce Tranche 1	15				15
Workforce Tranche 2*		15			15
Sickness, Maternity etc.		7.5			7.5
Expenses		10	21.7	8.3	40
Premises			15		15
Inequalities			5	5	10
Digital and access		5.5	8.7		14.2
Quality		2	3		5
Digital prescribing		8.14	0.4	0.82	9.36
Total additional  funding	15	83.14	85.4	65.82	249.36
Total in-year  funding (cumulative)	15	98.14	183.54	249.36	249.36

Workforce

By 2028/29, a total recurring £148.3 million is allocated to improve retention and recruitment of the workforce. With record numbers of trainees in the pipeline, this gives us the opportunity to offer careers to those newly qualified as well as address underemployment in the existing workforce. It also allows practices to employ members of the General Practice team such as administrative and nursing staff. However, we must stress that the fundamental purpose of this money is to improve GP Whole Time Equivalence (GP WTE) across Scotland, enabling safer working and better access and quality of services to the people of Scotland.

The £15 million already made available this financial year will become recurrent with an expectation of quarterly reporting on practice workforce numbers by practices. This improved transparency will grow Scottish Government’s confidence for future investment into General Practice to help deliver the longer terms aims of Service Renewal.

Enhanced Locum Cover

For 2026/27 the Statement of Financial Entitlements to Practices will be amended to support locum reimbursement for sickness from day one of absence. This will help protect services and help boost the locum market. It will also see an overall increase of approximately 28% to the weekly entitlement for sickness, maternity, adoption and paternity leave, rising to circa £2200 per week.

Expenses

Direct reimbursement of non-staff expenses will be introduced in phases, supported with a £10 million investment in 26/27. In future years this will be increased to a total of £40 million. In order to fully cover the liability, there will be some contribution from Global Sum in years to come but we believe this is good value to the profession to mitigate these liabilities.

Premises

The paused Sustainability Loan Scheme will be recommenced with a new fund of £15m from Scottish Government expected to deliver all tranche two loans during 27/28 and 28/29. Remaining tranche one applications will be completed during 26/27.

Digital and Access

Through the deal, £14.2 million will be used to improve digital and access solutions for practices. All practices will be supported to adopt cloud based telephony systems. Data from these systems will be shared with Health Boards to understand flow and demand. All practices will also be enabled to offer DACS (Digital Asynchronous Consultations Systems) for patients but will have control over how they use DACs to avoid any pitfalls which have been seen elsewhere. GMS regulations will be amended so all practices have a contractual obligation to provide online, telephone and walk in access for patients but please be assured that the mix and flow management will remain the discretion of the practice.

Quality

Five million pounds will be made available to support Protected Learning Time, enhancement of PQL and CQL rates and to enable a Quality reporting framework, using metrics that require minimal Practice effort. There will also be the establishment of mandatory Interface Groups in every Board, ensuring much better communications and understanding of workload transfers in a fair and supported manner.

Digital Prescribing

This programme will be finalised and delivered using an additional fund of £9.36 million per annum. This will have significant secondary cost savings to practices and patients. It will also be beneficial environmentally, not only reducing paper and toner consumption but a reduction on patient miles, chasing paper prescriptions.

Health Inequalities

A fund of £10 million will assist in addressing health inequalities. We have made it clear, that although welcome, the impact this will have on such a significant challenge within Scotland will be commensurate to the funding. We continue to work with Scottish Government on how we can offer bespoke support to Practices with significant deprivation as well as remote and rural challenges.

Enhanced Services and Seniority

We have a commitment from Scottish Government to review the entire Enhanced Service framework across Scotland over the coming years. There is opportunity to use the framework to deliver new services withing General Practice in a fair and equitable manner, as well as offer the bespoke support some Practices require. We have discussed the ability of this Framework to offer a just transition of services into the community and a mechanism by which new asks become routine business in future contractual arrangements.

We have also agreed to review seniority over the coming years, ensuring that we offer a scheme that looks to retain highly experienced GPs and reward their commitment to the service.

Summary

This recurring, increasing investment over the next three years gives the profession a generational opportunity to make working in General Practice in Scotland the rewarding, safe and sustainable career it should be. It provides the chance to significantly improve services for the people we serve by finally beginning to shift resource into the community, and general practice specifically, the bedrock of the NHS. Put simply, it will allow us to build a health system in Scotland that is fit for the future. Many negotiations and challenges lie ahead for us all but for the first time in a long while, the profession can look to the future with a growing confidence and optimism. We need to seize this opportunity and celebrate the outstanding service General Practice can be when in receipt of suitable support.

Dr Iain Morrison, Chair BMA SGPC, Dr Chris Black, Deputy Chair BMA SGPC and Dr Al Miles, Deputy Chair BMA SGPC