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GPs working in new A&E 'streaming' centres to have pay capped at £80

Exclusive NHS England has instructed hospital trusts not to pay GPs more than £80 per hour to staff its £100m GP-in-A&E scheme.

NHS England said the cap was put in place to align with the 'indicative rate' for GP locums that was set last year, but GP leaders warned it would discourage experienced GPs from taking on the roles.

The news comes as NHS England announced a further 27 hospital trusts to receive a share of the Treasury-allocated £100m funding last week, having said it expects all 139 trusts to have set up GP streaming by next winter.

The news of the cap was unveiled via a Pulse investigation into the planning process at the first 70 trusts to be allocated funding.

Pulse asked how much they planned to pay GPs, what kind of cover was needed and how they expected to recruit GPs, finding that a majority were at the very early stages of planning despite the time limit. However, some trusts told Pulse that the pay rate was already determined in NHS England guidance at £80.01 per hour.

Asked by Pulse, the Department of Health confirmed that this was the case, and added that hospitals had to adhere to the cap in order to receive a share of the Government's overall funding for the scheme.

A DH spokesperson said: 'NHS England's advice to trusts was that, in defining the service, the rates of pay for GPs should be no higher than the NHSE guidance of £80.01 per hour.'

But this comes as for GP practices to date, the £80 top rate is merely 'indicative', meaning they can pay above this but must report it to NHS England.

Dr John Ashcroft, executive officer at Derby and Derbyshire LMC, warned that the cap would mean only newly qualified, inexperienced GPs would go for the roles, hampering the Government's hopes they would reduce pressure elsewhere in the urgent care system.

He said: ‘They’ll go native. They’ll revert to being casualty officers rather than acting as GPs because they haven’t had enough time and experience in general practice.’

In Derbyshire, most locums cost at least £80 per hour, with more experienced locums costing closer to £100 per hour, Dr Ashcroft added.

The investigation also revealed some detail about the level of cover needed. Shrewsbury and Telford Hospital NHS Trust has said ‘one or two’ GPs will be available in the A&E from 8am to 11pm daily. East Sussex Healthcare NHS Trust has said each of its two sites will include GP cover from 10am to 10pm.

GP leaders have said the plan could make the situation in general practice worse and waste money.

Dr Richard Vautrey, GPC deputy chair, said: ‘At a time when practices are closing because they can’t recruit GPs, the Department of Health should be prioritising any available investment in to general practice, not establishing a scheme that attracts more patients towards A&E with the encouragement of being able to see a GP there.

‘This has the potential to make the situation worse not better, and waste £100m in the process.’

Pulse previously reported that it would require up to 420 extra GPs to implement.

When asked how it plans to recruit GPs, a spokesperson at Taunton and Somerset NHS Foundation Trust said they were unconcerned about recruitment as ‘GPs tell us they like working in A&E, and enjoy the teamwork and the type of medicine they can practise there’.

Readers' comments (40)

  • 8 hours a day, 5 days a week, 46 weeks a year = £ 147,200. Not bad at all. Trust job and will be crown indemnified. Less responsibility. Any doubt, refer.

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  • Vinci Ho

    We are where we are.
    The right or wrong is beyond us anyway . It is perhaps a 'choice' for some when one weighs up the pros and cons in individual case. Partner , salaried , portfolio, academic, A/E and commissioning etc . You skilled up one way but got deskilled other ways . Question is exactly what is 'bread and butter' our health service really needs?
    ''We have now sunk to a depth at which the restatement of the obvious is the first duty of intelligent men.''
    Are our political leaders 'intelligent' enough?

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  • There is such bickering between GP's and Hospital doctors . Each makes assumptions on the other's skill, pay , levels of stress.I find it sad.

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  • Cobblers

    Divide and rule. Standard doctrine to beat the opposition. Seems it is working between Hossie Docs and GPs.

    If they want GPs then they set a pay rate and Ts & Cs and wait for interest.

    I suspect they will wait a rather long time.

    As for going rate I smile when I see OOH offering £100 per hour now when in the early 1990s that same rate was going for the local Doctor On Call service. £150 per hour on Xmas day and Boxing day. 25 YEARS ago.

    Needless to say the rota filled quickly.

    As the obvious hits home I suspect that the ED (AEU) rates will increase quietly.

    But I have found my comfy niche. It does not involve ED and the stress that goes with it. Been There Done That Got The T-Shirt.

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  • T cut through the arguments it is important to understand one thing:
    This is a capitalism - which means you do not take and accept or get offered what you are worth, but instead get paid accept or get offered the market rate.

    That is why locum prices vary from place to place. in some places 80/ hour is a reasonable rate. In many other areas (inc ours) it is the very floor of the pay scale.

    I make a lot more than 80GBP/ hours as a partner.
    Our locum doctors make closer to 100GBP/hour and we still struggle to fill them at short notice.

    And to top things off there is no goodwill left in the system to encourage GPs to accept pay at less than the market rate.

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  • If they are paying the market rate, the posts will be filled, if not they wont .Waiting with baited breath am I.Not enough for me though.Full time GP partner my current existence.

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  • I wouldnt at £80 - on the other hand you will be an employee of the trust with all the rights that go with it

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  • Hmmm... Can't believe I'm typing this but I'd be interested as long as there was indemnity/training provided. Could be a nice addition to a portfolio career. Also good to have holiday/sick pay etc....
    I think the biggest issue I'd have is that I think like a GP and would want to get a patient sorted out - not bounced back to primary care if that's not appropriate.

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  • AlanAlmond

    The market decides pay..not a department of worthiness.
    Do bankers get paid offensive rates because they are good and worthy people? Not at all. If something is difficult to get hold of and people want it it's valuable...try to go against this and you'll end up without ...but evidently feeling deeply miffed and entitled all the same

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  • Where are all the GPs coming from?? There are not enough to keep surgeries functioning, they want 7day opening and GPs in A+E anywhere else???

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