This site is intended for health professionals only

At the heart of general practice since 1960

Read the latest issue online

A faulty production line

Almost two-thirds of GP practices will see funding boost from new contract

No GP partner in Scotland will earn less than £80,000, as well as measures to reduce workload and protect partners from risk as part of a ‘historic’ new contract in Scotland.

Meanwhile, almost two thirds of GP practices will see their overall funding increase based on a proposed new funding formula.

Around a fifth of GP partners should see a pay rise under the proposals that will also see a £23m funding injection into the GMS contract and all practice expenses - including staff and premises - being funded.

Under the agreement, there is also a commitment that no GP will own their own premises by 2043, while there will be extra funding to ‘significantly reduce the risks to GP partners from providing their own premises making it easier to attract new partners’.

The chair of the BMA’s Scottish GP Committee said that the new contract ‘offers income stability and reduced business risk to individuals’. 

GPs will be able to vote on whether to accept the new contract following a special conference for LMCs on 1 December.

Pulse has already reported on a number of the measures listed in the contract announcement, including:

Also announced in the contract is a two-stage reform of the funding formula. As part of ‘phase 1’, the formula will be changed to give more weight to those practices that look after elderly patients, and those in deprived neighbourhoods.

No practice will lose out as part of this phase. The contract states: ‘A new practice income guarantee will operate to ensure practice income stability. The new funding formula will be accompanied by an additional £23 million investment in GMS to improve services for patients where workload is highest.’

In April 2019, the Government will guarantee that no GP partner earns less than £80,000 per year.

The contract agreement states: ’The contract offer proposes to introduce a new minimum earnings expectation to ensure no GP partner earns less than £80,430 (including pension contributions) NHS income for a whole-time equivalent post from April 2019. Evidence indicates this will benefit approximately one fifth of GP partners in Scotland.’

Under phase 2, due to begin in April 2020, there will be pay progession and a guaranteed income range - similar to that of consultants - and that all expenses will be covered.

There will be a ballot of all GPs before this is implemented, however.

GPC Scotland chair Dr Alan McDevitt said: ’Our aim in these negotiations has been to make general practice sustainable for the future. It was clear that significant change was required to address the increasing workload pressures that colleagues were facing.

’Practices have been struggling to recruit to vacant positions and we have started to see this impact on patient care, with some practices closing their patient lists, handing back responsibility to the health board or in extreme cases having to close altogether.

‘This contract offers solutions to the pressures faced by general practice. By expanding the primary care team and working with integration authorities to improve patient access to services delivered by other professionals, such as, practice nurses, pharmacists and physiotherapists, GPs can have more time to concentrate on being GPs.’

He also told Pulse: ’There is a new formula which gives a higher weight to workload, so market force factors are out, rurality is out, and it will be based on deprived patients and elderly patients. 63% of practices gain from that formula change but no one drops as a result of that.’

Readers' comments (33)

  • Hardly a carrot

    Unsuitable or offensive? Report this comment

  • Not convincing when the daily rate for locum GPs is £600-650 per full day and rising. woeful.Free market economics at work.Lack of supply increasing demand and cost.

    Unsuitable or offensive? Report this comment

  • 80K for a full time partner, obviously there is no private practice for GP, hardly worth going to medical school now, better you run a restaurant in Glasgow and would earn same or more

    Unsuitable or offensive? Report this comment

  • deduct 10k for MDU and pension included in 80k

    Unsuitable or offensive? Report this comment

  • Assuming the "pension contribution" means the employers contibution that means the income would be just over £70000!
    Before Defence subs and expenses

    Unsuitable or offensive? Report this comment

  • Really is this the best they could do?? I dont know any whole time GPs earning £80K. Who is going to go to medical school and train to be a gp for this salary? Does Alan Mc Devitt think this is a realistic figure?? We get access to treatment rooms though and can get bloods and dressings done.Game changer! What about access to MRIs, Echos, BNP etc. How about the government and their advisors use their imagination. Have we really waited all this time for this rubbish. How about a tax free allowance (up to 20K say) for doctors working out of hours. That would recruit and retain better than this nonsence. How about empowering GPs rather than deskilling. I know what way I will be voting.

    Unsuitable or offensive? Report this comment

  • You get monkeys when you pay peanuts

    Unsuitable or offensive? Report this comment

  • Sometimes I think changes have just not been thought through properly. I have not seen the full wording so cannot be 100% clear re if there had been any safeguards to 'prevent' this, but to me:

    Full time means 37 (or 40) hours/ week.
    not the same as 10 sessions or 8 session.

    I fully expect GP to reorganise their time so that they are now working reasonable safe hours (40) safe in the knowledge that their income will be protected. As much as people complain, that will be a significant improvement on the hourly rate of some partners currently earning 100k/ 80 hour week as long as GPs have the will do impose 'full time' properly.

    The problem is that it will make the shortfall of GPs even worse (in the short term). The answer is to change that in to an hourly gross rate (45 GBP/ hour based on 40 hour weeks and 45 weeks/ year) and make sure GPs get that, even if they work 60 or 80 hours/ week.

    That is still not enough though.

    Unsuitable or offensive? Report this comment

  • The income guarantee is just one part of this package. And yes for many GPs it does not sound a lot but the evidence we got through the recent Deloitte study of Practice accounts showed that a significant number of partners currently received less. So as a start we want to bring them up, and £70k is after practice expenses (which include MDO costs if the Practice pays this) plus the employers superannuation at +14%.
    And if you have access to treatment rooms already that’s good but many GPs don’t so we want universal access as this is a growing area of workload as hospitals shift work out. Access to tests is something that needs dealt with locally. Again some GPs have this already.
    I would encourage you to read the full document and come to the roadshows.
    Pay is part of the solution but so is workload reduction and the ability to spend most of our time doing what we are trained for what we are calling the expert medical generalist. We need to make general practice more attractive - boosting the GP workforce is key.
    Today’s proposal is only part 1 in that process

    Unsuitable or offensive? Report this comment

  • The elephant in the room is - what is whole time equivalent? 7, 8 or 9 sessions? 40 hours?

    80K for 8 sessions work is 9K per (6 hour) session after indemnity paid.


    Unsuitable or offensive? Report this comment

  • We Scottish GPs are a patient lot having waited since 2014 for a new contract and one year late this is the best that the BMA and Scottish Government can come up with. I do not foresee a rush to fill GP training places based on this.

    Scotland's GP service might be in crisis but there seems to be no rush to get much needed help direct to Practices, additional staff will not be finally delivered until 2021 and there is neither a workforce plan in place or an agreement from Health Boards to employ them.

    In 2019 we get the headline figure of £80 000 minimum income guarantee for a full time Gp Partner which after removing Employers superannuation and defence fees ( 2K in Scotland) falls to £66 500 for a GP who may have may years experience. In comparison the starting salary for a consultant here is £78 000.
    The BMA needs to reflect on why their poor negotiating skills have left Scottish GPs with falling income which is the lowest of all the UK countries.

    Premises is a major issue and waiting till 2042 for GP owned premises to be taken over by the NHS is certainly taking a long term view.

    Phase 2 sounds like a move towards a salaried service with a hoped for consultant equivalent payscale. But page 21 lets the cat out of the bag as they cannot agree affordability and may never happen even if we wanted it..

    I suspect many Scottish GPs will find it hard to find much that is going to transform their working lives in this damp squib of a contract proposal. The new money needs to go to practices so they can find solutions that suit their local circumstances and help manage increasing demand.

    Unsuitable or offensive? Report this comment

  • Just Your Average Joe

    80000 a year for 40hr a week over 52 weeks - works out at less than £40 pounds an hour.

    Sure that it sounds like a good idea to health board who would have to take over returned contracts and pay at £100 plus an hour for just surgery time - so all the behinds the scene work, visits etc would need separate funding/people to do the work.

    So 80000 a partner looks like the cheap option - sadly the 20% of colleagues for whom this is an uplift - need to be valued greater and paid their worth regardless.

    Unsuitable or offensive? Report this comment

  • Dr Buist. Is that the 'Early Bird' offer ('Once-Off - Get it while you can')?

    Unsuitable or offensive? Report this comment

  • Rogue1

    Or, just work as a locum for £130k/yr, with no responsibility, its a no brainer!
    Until they address the imbalance the situation is only going to get worse

    Unsuitable or offensive? Report this comment

  • Dr Buist, should I be considering 'food banks' and my younger colleagues with student loans be applying for social housing?

    Unsuitable or offensive? Report this comment

  • This is around £45 an hour before pension subs and tax. Absolutely pathetic for a fully qualified GP nevermind a partner with all the business risk.

    Unsuitable or offensive? Report this comment

  • @Shaba
    Our list sizes in Scotland are smaller and we have therefore always lagged substantially behing English earnings- a trade I have always gladly made because I feel we have more time to gain better job satisfaction.
    I haven't had time to read it all yet, but I think the £80K mimimum in Scotland reflects the fact that quite a lot of hardworking FT partners in certain areas currently earn less than this and bringing them up is much needed. No suggestion as far as I can see that anyone will be earning less- although devil may be in detail.

    Unsuitable or offensive? Report this comment

  • As a GP in the Inverclyde area (which was essentially the pilot area for this new contract) I am not surprised by it.Despite the rhetoric the reality is we are just not valued by the Scottish Govt. It has been clear to me that their vision for the future involves delegation of our role to allied health care professionals and unfortunately the BMA have colluded with this vision. Family medicine is a specialty which takes years of training to master and is not something which can be easily delegated to others with only a few weeks training. Rather than acknowledging the need to invest heavily in producing a new generation of family doctors they have chosen to waste the extra resources which have been made available. There is nothing in this contract which will improve recruitment or retention and I feel an opportunity has been missed. Right now I feel sorry for my younger colleagues who ,unlike me, do not have the chance to get out in 3-4 years time but I suspect ultimately we are all likely to be losers in the long term. I for one am fearful about which healthcare professional will take overall responsibility for my health when I get older.

    Unsuitable or offensive? Report this comment

  • Dear Glen Sykes
    I'm sorry you are not enthused. Being based in Inverclyde you will have benefitted from a pharmacist being added to your team. The evidence I have seen shows a 50% reduction in GP time spent in this area, but we need to go further. If your time is anything like me you spend up to an hour a day doing prescriptions - specials, repeats, high-risk drugs, shortages,reconciliations - this is work that should be done by pharmacy services, giving you back an hour a day to do what only you as an EMG can do. Similarly practice nurses currently get tied up doing things that we propose treatment room services should deal with, we propose to refocus practice nurses time on CDM and minor illness management the intention again being to free up some of your time. GPs are in short supply, we are the highest trained and paid clinicians in the community so we need to use our time approprairtely. What is in this for younger GPs is they will have more time to carry out their key roles, spending less time providing care that other healthcare staff can provide.

    Unsuitable or offensive? Report this comment

  • in my experience PNs and additional Primary Care staff just don't accept responsibility and need to persistently involve GPs. Health Board Pharmacists in our practice work quietly in their rooms once a week, with limited tasks and at the end of the day the remaining tasks are passed back to the GPs as they don't have the time to finish everything!

    This new contract of ours isn't going to address this, and as in an aforementioned comment we have waited patiently so very long for this contract to find that we need to tread water for another 3 years to receive the "help" of a risk averse and limited abilities of support Primary Care teams! We are drowning at this moment!

    Unsuitable or offensive? Report this comment

  • least you guys have a contract and some vision of the Northern Ireland we are left in a total wilderness.....

    Unsuitable or offensive? Report this comment

  • Is that it?
    80k before expenses

    Unsuitable or offensive? Report this comment

  • Reality check

    A train driver is on £60K without overtime

    Unsuitable or offensive? Report this comment

  • David Banner

    "A fifth of partners will receive a pay rise"
    So 80% will see no pay rise (or more likely a cut....again).
    If I worked in Scotland I wouldn't be cracking open the Irn Bru just yet.
    As Shaba said........ Pathetic.

    Unsuitable or offensive? Report this comment

  • After having looked over this I am actually more hopeful than I have been for some time. I don't think that there will be much in the way of pay rise, but if things go as stated then I might have less worry and also get some of my life back in terms of hours worked.
    Confirmed that the absolute minimum take home will be £80k, but this is to take the 20% of GP FT partners who currently earn less than that away from that ridiculous situation.
    MPIG to get wrapped into global sum, immunisations to be taken away without loss, local health hubs to manage hospital requests for dressings and bloods.
    Longer term ideal to take practice leasing or ownership concerns away from General Practice, and deal with the urgent ones now.
    I'm sure as with the QOF there will turn out to be things to hate too, but I think a lot of thinking and work has gone on here. Roadshow will be interesting.

    Unsuitable or offensive? Report this comment

  • Dear Dr Buist,
    you are quite correct we have had the benefit of 2 pharmacists and a pharmacy technician. This is of course a cornerstone of the new proposals-our allied healthcare colleagues helping to soak up our workload and free us up for complex consultations. I am afraid the reality is somewhat different . Whilst i accept the pharmacists have improved safety and quality they have actually increased workload. This is mostly entirely appropiate (eg. asking patients to attend for review of SSRIs) ,however, it does increase the number of patients attending you who have been asked by the pharmacist (usually by letter) to see their GP to discuss medication. I would strongly advise against following any "evidence" or audits presented by the Scottish Govt. to show how much of our time can be saved in this me that is very far from our experience!

    Unsuitable or offensive? Report this comment

  • The real problems that remain are:

    1. No brake on access. So even if this does free up some GP time, which is debatable, the newly created spare capacity will be taken up by more demand from patients for access, counseling, greater explanation of their disease etc. There is no limit to what patients want and expect when everything is free up front.

    2. No payment for volume activity.

    Unsuitable or offensive? Report this comment

  • What happens if Gp's vote to reject this contract?

    Unsuitable or offensive? Report this comment

  • Agree with Glen Sykes. From personal experience, pharmacy ‘support’ creates vastly more work than it relieves. Does to a large extent depend on the individual pharmacist, with some generating considerably more work than others. The administrators seem to think that same qualifications + same courses = identical clones. With increased numbers there is likely to be a higher proportion of unsatisfactory experiences.

    Unsuitable or offensive? Report this comment

  • 1 The contract offer proposes to introduce a new minimum earnings expectation to ensure no GP partner earns less than £80,430 (including pension contributions) NHS income for a whole-time equivalent post from April 2019.

    I worked at a GP practice where none of us worked as full time GP. That said, one 8 session GP was doing 60 hours per week some weeks. I think we need a solid definition of what full time is and what actually is.

    2 The GP partners will still have to see the surplus of patients as other health professional will see a finite number of patients in a defined period of time.

    3 I worked with some very good Nurse Practioners seeing selected triaged patients. However they still need supervision which does add to work load. At the same time the GPs were seeing the more complex patients . Because they were more complex, they did require more time both clinically and administratively to sort them out. I can't see this being factored in unless the number of patients we see are cut back.

    4. There is a still a financial risk to GPs. Even if you are in a practice doing everything you are required to do and you still go under, there is the redundancy packages to pay

    Unsuitable or offensive? Report this comment

  • In the 70s there were vacancies and influx of overseas gps and gosh the standards dropped as no training and so hospitals were the place to go.
    Now I see some of that happening. .
    It will be like the dentists and vets doing minimum training and starting practice . Why bother with a 10 year training for the crumbs off NHS work.

    Unsuitable or offensive? Report this comment

  • Corrected 'TOXIC crumbs'.

    Unsuitable or offensive? Report this comment

  • £80,430 looks like an odd number to choose as a minimum income until you notice that it includes 14.9% employer's superannuation. Deduct this and it works out exactly at £70,000. A nice round figure, which is less than the lowest band consultant pay.
    This sum is being sold as a minimum rate but it will be judged by the Daily Mail etc as a benchmark and anyone earning much over this rate will be castigated as a fat cat GP. Agreeing this is a strategic own goal against the profession.

    There is no set timetable in the contract for recruiting extra staff to do the routine work we now do, leaving us free for the extra work. There is no requirement that we only get extra work once relieved of the current workload.

    Unsuitable or offensive? Report this comment

Have your say