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The sting in the tail of the 2% 'pay rise'

The Government's 4.2% contractual funding uplift fails to convince, finds Sofia Lind

GP practices will receive a 4.2% uplift to total funding in 2018/19, after the Government concluded its review of public sector pay rises this week.

They said this would translate to a 2% pay rise for GP partners, backdated to 1 April, and would be enough to cover practices to increase pay for salaried GPs and other staff by the same amount.

But the announcement – the first official statement from new health secretary Matt Hancock - was not received well by the BMA GP Committee, which pointed out that the 2% so-called pay rise was below the 4% recommended by the independent pay review body – that, they say, was needed ‘simply to keep services for patients running’.

GPC chair Dr Richard Vautrey said: 'It is deeply concerning that the Government has chosen not to honour the findings of its own independent pay review body across the entire NHS, but specifically for GPs.’

DDRB recommends 4% pay rise

The Review Body on Doctors’ and Dentists’ Remuneration was emphatic in its recommendation that GPs must receive a higher pay award than the 2% it recommended across doctor and dentist specialists to improve retention.

It listed a number of ongoing pressures on GP partners, including:

  • Changes to their role and demand increase ‘as a result of the greater integration of healthcare with social care’;
  • The ‘increasing demands posed by a rising and an ageing population with more complex needs’;
  • The ‘increasing regulatory and administrative burden of running practices’
  • A ‘decreasing willingness’ on the part of younger GPs ‘to work the number of sessions their predecessors worked’, and their tendency to ‘prefer salaried employment to practice ownership’; and
  • The ‘fact that average gross earnings for [GPs], both contracted and salaried, were lower in nominal terms in 2015-16 than in 2006-07’.

The DDRB report concluded: [W]e believe that if sufficient number of GMPs are either to be recruited from overseas or encouraged to remain in the service longer than they otherwise would have done, a pay response is required now. Such a response needs to be significant and go beyond our recommended base increase for the pay remit group as a whole.’

It recommended that GPs should receive an additional 2% pay increase, above and beyond the minimum 2% rise recommended for the doctor profession as a whole.

However, the Government’s statement took a different approach to the same problem.

Mr Hancock said: ‘GPs face a significant challenge in numbers and we need to recruit large numbers over a short period, meaning any pay rise needs to be balanced against our aim for a growing number of practitioners.’

Dr Vautrey was scathing in his analysis of the stance: ‘For the new secretary of state to commit, only last week, to addressing the workforce crisis in general practice and raise hopes of investment in primary care, to now dash those hopes, will signal to dedicated GPs and their staff that they are not valued.’

GP accountant Bob Senior, head of the medical services team at RSM and chair of the Association of Independent Specialist Medical Accountants (AISMA), said the uplift would not ‘do much to help with recruitment nor retention’.

He said: ‘Even if it did translate to a 2% increase in practice profits – and I don’t know if it will, with inflation running at 3% and all of the added cost pressures – I wouldn’t say it is adequate.

‘I doubt there are many GPs who thought that it would be a big increase but they will be disappointed that the Government isn’t putting the extra £20bn promised for the NHS into general practice.’

1% extra funding uplift dependent on contract reform

Thrown in as an added bonus, the Government said GPs would be getting an extra 1% pay rise from April 2019, if they agree to the contract reforms that are currently under discussion (including the partnership model review, sweeping QOF changes, and a move to a funding model enabling 'digital-first' general practice).

When pushed to explain the meaning of this – would GPs get a maximum 1% pay rise next year? Just like during the years of austerity public sector pay caps? The Department of Health and Social Care explained that no, this would go into the contract baseline, and form the starting point from which next year’s uplift negotiations would begin.

A Department of Health spokesperson told Pulse that GPs are getting the standard 1% pay lift this year and the extra 1% backdated to April 2018.

The other 1% on top of that is conditional on agreement to a multi-year contract. If that is agreed, the pay award for 2019/20 will start from that baseline figure – 3% more than 2017/18. In effect, this will be very minimum they will receive.

Whether this 1% extra incentive will mean much for GPs is another matter, but it does make clear the importance the Government is putting on contract reform.

Mr Senior said: ‘I think there are likely to be bits in there that the GPs won’t like – otherwise the Government wouldn’t be taking this approach.’

In numbers – the Government’s GP pay announcement

  • Total GP funding uplift rises from the 3.4% provisional uplift announced in April to 4.2%.
  • An additional 1% uplift to the contract baseline to be applied from April 2019, subject to contract reform agreement.
  • The DHSC claims this translates to a 2% pay uplift for GP partners - 'worth £2,000 per year to a GP contractor with a median taxable income of £100,000' and 'around £1,052 for a salaried GP with a median taxable income of £52,600'.
  • Minimum and maximum pay scales for salaried GPs will rise by 2% from 1 October.
  • The GP trainer grant and GP appraiser fees will be increased by 3% from 1 October.

Source: Department of Health and Social Care

 

Readers' comments (18)

  • The government must drop their Vendetta against GPs and acknowledge Market Forces.

    Like King Canute, they are convinced that they can hold back the tides of change.

    GET A GRIP.

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  • Playing Euromillions tonight. Fingers crossed.

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  • Plan b?

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  • This is not going to stop the tide coming in on the communist healthcare system and washing it away, with luck maybe the Tory Party too.The pressures on the NHS have not stopped this year rolling into a winter season it is in deep trouble.

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  • Time for some real action.
    We all know full strike action is unlikely to work. Those with successful practices are unwilling to risk breach of contract notices.

    So what is needed is progressive movement towards working to rule. Simple things like directing ALL emergencies to a&e. (No contractual obligation for emergencies)

    2 weeks later all go practices withdraw from extended hours.
    2 weeks later a total cap on appointments seen, rest directed to A&e
    2 weeks later ALL shared care deals get referred back to sole secondary care
    2 weeks later all GP practices stop phlebotomy
    Etc etc

    Always pick stuff within the contract rules (might lose enhanced service funding) so no breach notices
    All visible to the general public, planned and up front
    All cost the hospital sector a lot of money.
    And there are probably more than a years worth of tasks we can take out of our workload.

    Even if not successful, It might change the approach of GPS for the better.

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  • doctordog.

    Some great ideas, but will never work because of the endemic messiah complex in the GP workforce.

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  • AlanAlmond

    Ok I’m going to sound like an arse but here goes. Went a GP update course recently, loads of GPs milling around, I was struck by how totally lame, passive and limp they all looked. All very nice, all totally approachable, would have been happy to burst into tears and pour my heart out to probably 80% of them if the shit hit the fan but if you were looking for an easier bunch to shepherd off a cliff you would have had a hard time finding a more agreeable bunch. We ain’t got no balls any more , maybe we never did , we’ve got a collective ‘take advantage of my lovely nature’ written all over us, it’s in the training ..were like the drippy next door neighbour in the Simpson’s. Unless we get a spine and learn to be difficult general practice will continue to morph into a group of meak bottom wipers. Looking around we don’t seem to believe we deserve much better.

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  • Re Utter Fool
    Okeley dokeley neighbourino!

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  • Unfortunately communism can be failing yet still takes decades to be overturned.

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  • 1% wont make want to change my contract....changes as suggested above may make me quit instead

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