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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)

  • I can't believe we are all arguing about money between ourselves. We really don't value our experience at all. My husband works as a laywer and tells me the junior partners in their firm, just out of traineeship earn £100K and they can't retain them as elsewhere they are earning £125K when they are just starting out, and this is NOT in London. It makes me so mad the press portray us as greedy and overpaid.

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  • Cobblers

    Lostthewilltolive I cannot but agree.

    We have gone from independent professionals to practically salaried lackeys inside a generation. I blame no-one apart from civil servants and multiple governments intentions and a degree of nihilistic pacifism within the profession as a whole.

    I suspect it is irredeemable but, ever in hope, I look towards the GMS/PMS contract failing and alternatives springing up where the value of the work done in GP is recognised and the pay rates set accordingly. The only way that will work is to have negotiators with cohones or a more private based system.

    As ever the 'Cardies' will be there to drag our value down.

    Nice day out there :-)

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  • @1.22pm

    I am with you.I have a little knowledge of cost accounting, and worked out a long time ago that my hourly rate should be no less than £150.00 per hour

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    What about factoring in agency costs when locums are required to fill staffing shortages?
    As a gp affiliated to the Accident and emergency .. it is all fine when the cases triaged are general practice manageable .. i.e not needing immediate investigations
    otherwise it becomes very risky
    Similarly if the GP is seen as a sneaky admission route without working up cases .. then why bother
    simply have an arrangement to allow A+E to triage cases directly to admitting teams.. (where it is safe to do so )??

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    it is not the case that gp's feel that they are worth more than hospital consultants .... Rather it is the case that the hospital consultant should similarly value themselves a lot more... Yes A+E has a lot more risk and stress ... let us GP's value our selves and let Hospital consultants value themselves above that if they feel that way.

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  • i am being paid 95/hr to work in a&e, even then i do only 1-2 shifts a month. if they reduce it i will just cancel it, i have cancelled all my shifts my ooh provider in last 6 months due to fixing of rate of 80/hr. doesnt make any sense paying 20000 per yr mdu fees to work for these i...ts. i know there are still may people who do for 65/hr- all you need is one complaint landing and mdu fees rocketing

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  • As a new GP I never negotiated beyond what was offered. Now I do and do not feel ashamed about it. Be ready to say no if they do not accept you expected rate and do not bother about rest. Caps fall apart as for as my experience is concerned or they should be ready to leave shifts unfilled. Late evening at £80-they must be kidding

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  • As a return to work GP earning NOTHING for 3 months I have no problem in getting paid a reasonable rate. I have still had to pay GMC & MPS fees despite having been off work for over 3 years. Now on my return no financial support from any NHS agency. I am grateful to this practice for the experience of a gradual return to 10 min appointments but the NHS is not a good employer. The BMA are useless, make doctors believe they should be grateful for being in work even when not being paid. No other "profession" would tolerate the rubbish work conditions. I would be more than happy for GP's to be actually employed and get employee perks of pension and indemnity and holiday and someone else to sort locums out etc.

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  • I'm an ED consultant of 13 years and some disco points, I get £45 an hour. 25% of my work is scheduled in OOH period.
    That's what they are looking at when they are setting a cap (rightly or wrongly).
    There is no "market" for us unless we locum or go abroad. British Doctors will not strike ( although I would). If you can get more money good luck to you, if this doesn't work then it doesn't work. Most people in EM strike a balance between job satisfaction and salary and live with it.

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  • All doctors in the UK are underpaid in my view and by rights those who trained more should earn more.
    Silly to have a race to the bottom attitude saying why should GPs expect more than 80ph when consultants earn less. They should be encouraging this and using it to aid their case for better pay themselves which of course they deserve.

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