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Revealed: Six areas across England move towards a salaried GP model

Exclusive At least six areas across England are moving towards mass salaried models replacing GP partnerships, while an increasing number of practices in Scotland and Wales are giving up their partnership status, Pulse can reveal.

A Pulse investigation into GPs going salaried found a number of areas where partners are giving up their practice contracts to work under hospital trusts, GP federations and the new models of care promoted by NHS England.

It comes after Pulse reported that more than half of GP partners would consider taking a salaried role if it was the right deal. 

The GP partners moving to a salaried model cited workload pressures and fear of becoming 'last man standing'. 

Pulse has already reported that a majority of GP practices in Gosport, Hampshire have decided to take on a new employed status, working under the local community trust. 

But the investigation has revealed that there are a number of areas where GP partners have been giving up their practices and working as salaried GPs under larger organisations.

They include:

  • In Wolverhampton, where a pilot project will see a number of GP practices employed by the Royal Wolverhampton NHS Hospitals Trust;
  • A Hull local GP federation has taken over the running of two GP practices after approach from partners, who have stayed in post as salaried GPs;
  • In Somerset, a new model of care run by the local trust may come to hold 10 practice contracts, employing the current partners
  • In Sheffield this March, a mental health trust and a GP provider company won a bid for an APMS contract to run five GP practices, covering 21,500 patients with a new salaried service.
  • In Wales, ten practices have been taken over by health boards, while another eight are at risk;
  • In Scotland, practices are increasingly coming under health board control;
  • NHS Humber Foundation Trust taking over the 9,500-patient Market Weighton Group Practice on 1 April, after being approached by practice partners due to PMS cuts and recruitment problems.

Dr Stuart Morgan, a senior partner at the Brune Practice in Gosport, wrote on his practice website: about why the practice partners were becoming salaried under Southern Health: 'Coming from a historically low point, we are realistic about the help available to enable us to deliver the range and quality of care we desire to provide.

'However, we are moving forward with cautious optimism. I remain determined to see this process through to completion - for you, for my colleagues, and for our superb team of staff - and to work with Southern Health to ensure a service for our patients that is both sustainable and continuously improving.'

Dr Julian Parkes, a GP who has become salaried under Royal Wolverhampton Trust, said making life more tolerable for GPs was a factor. He added: ‘We want to see a better service for patients and less stress for GPs. We have lost the grief of being a small business and issues with staff.'

In Scotland, GPC chair Dr Alan McDevitt rolled back on his quotes last year that contract negotiations were looking at a model ‘as close to salaried as possible’ after a survey found 85% of GPs wanted to retain independent contractor status.

However, he added: ‘Salaried options will remain and are the current default if a practice becomes unsustainable but we believe the future is a strong, modern independent contractor GP model leading a broader primary health care team to better outcomes for patients.’

Pulse’s May survey of over 500 GP partners has revealed that a growing number are thinking along these lines.

It revealed that over half of partners in the UK (51%) would consider going salaried themselves, if presented with the right deal. Last October, just 26% of all GPs said they would support a fully salaried service.

Readers' comments (11)

  • Pros and cons. It is more risky but with the risk and responsibilities comes the payments. Do not forget your cost rent or notional rent and factor that in before changing to a salaried model. Being professional means being in control of your life. The dangers of a salaried model de-professionalise GPs and turn them into shift workers with shift worker attitudes.

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  • Quite confusing. I wonder if one of the four PARTNERS of the successful Hurley Group can throw some light and offer us some advice.
    Are they, for instance, considering joining a hospital trust, form a GP federations or apply the new models of care promoted by NHS England? My partners and I will certainly follow their example.

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  • Note sure if anyone realized but none of these models are GMS. This means they have no obligation to offer (luxurious) BMA model contract.

    I know there are disillusioned salaried GPs who thinks partners earn a lot more - this is incorrect. When factors such as employer contribution to pension is adjusted, income per hour worked at my partnership us £45/hr - not too different from average salaried GP earning/hr and a lot less then a locum.

    I suspect when APMS become the norm, it will drive down GPs pay and working condition, esp now we know we will no longer have European Working Time Directive soon. I hope enough GPs will have a foresight.

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  • Joining as salaried from an existing partnership where you own the premises can be dodgy. There's no guarantee of the duration of an APMS contract which could be squashed due to a serious breach and then who pay's the rent. NHSE may not want to use your premises or may step in to disperse the lot to another Provider leaving you with a bare property and a mortgage on your head.
    Cautious optimism has to be very cautious indeed!

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  • salaried post only for those who are salaried now or those who don't own premises. the rest will be in deep trouble. i sold premises and left practice 4 years ago and happily doing what love. just see patients , sort clinical problems and go home.

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  • Vinci Ho

    Caution is indeed the 'only' word and it is tied with this volatile , everchanging political situation . Very few people could predict MojoBojo would abandon his ticket to join the race of next PM. No matter what Justice Golf said , the word treachery(evidenced by what he said in live television asking people not to count him in only days ago)is written all over the place . Auntie May is looking set to win the race(though Heisensberg's uncertainty principle still applies). Ozzy is forced to give up his 'dream' of budget surplus by 2020(probably also the dream of next PM). More borrowing is coming and austerity has to be at least, on hold.One school of thought was to invest on infrastructures and relax public spending . In fact , for short term wise is logical .More quantitative easing may devaluate the pound further but more will put money into government bonds as well as the interest will remain very low at least for a while . Bear in mind , petrol price remains extraordinarily low. Brexit is a supernova with uncertainties and perhaps opportunities.
    As I said , it is all about revisiting central ground politics(look at what is going on inside Labour!)after all the 'fever and passion' of Brexit . Is Auntie May really the chosen one?And it is so bloody stupid for the far right guy( you know who)to taunt the other 27 EU members at this critical time and saying 'I told you so years ago!'
    For us , I would stand by all things great and small to exist , depending on your individual circumstances . At the end of the day , it is still all about surviving........(long sigh)......

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  • I am absolutely astonished, and am at a loss for words, as to the lack of intelligence of some GPs.HOW CAN YOU BE EMPLOYED IF YOU HAVE TO PROVIDE YOUR OWN PREMISES? This is one of the most important differences between being employed and salaried, for tax purposes.
    Dr Vinci Ho is discussing the future, about future leaders. Does it even deserve mention?
    None of the leave campaign are mentally retarded. At least not yet certified. They have made the UK POORER and FRAGMENTED, Why? To achieve their own great ambitions.

    Retired 5 years

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  • This comment has been moderated.

  • salaried ?do it if you don't give a S... about continuity of care ,call in sick at the first sign of a sniffle,work to rule ,don't do any work that's not in your contract,be prepared for short term contracts ,reduce your annual leave from 8 weeks to 5 weeks a year ,or live the happy life and stay in control of your destiny retire asap or locum, why on earth be salaried

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  • In 36 years as a GP, I have been a partner, salaried and a locum. If you work in a team, it is hard to fully control your workload if there are issues with your partners/employer. You can set out your expectations in any role but it all comes down to you and the team you work with

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  • In 36 years as a GP, I have been a partner, salaried and a locum. If you work in a team, it is hard to satisfactorily manage your workload if there are issues with your partners/employer. You can set out your expectations in any role but it all comes down to you and the team you work with give and take on all sides. In my experience it is the people rather than the model that determine job satisfaction.
    The only other difference I noticed was the tendency of some colleagues to denigrate my professionalism as an non partner.

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