An issue that my small practice (semirural and only 2000 patients with limited ability to attract more) faces is the difficulty in funding extra staff.   When the current contract came into being, the practice staff levels had been historically low.   In the ensuing years, the need for extra staff has greatly outstripped funding, and the complexity of work means that more anciliary staff have been required but also we would dearly love to employ a health care assistant full time.  This however would have to be paid for out of existing practice income which is not keeping pace with current staff inflation (as well as annual pay rise there is a significant increase as staff advance along their pay scale each year and there have been increases to employers national insurance and pension contributions.  Under the old contract, practices were able to apply for new staff funding or increased hours by applying to the health board, but this no longer occurs.

Being able to receive funding for a health care assistant would allow more time for GP and practice nurse to spend on other clinical matters.

I have given an example specific to my practice, but I am sure that this mirrors similar issues in many other practices.

I hope your deliberations are fruitful.

Regards,

Nigel Watkins