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Independents' Day

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)

  • 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.

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  • 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.

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

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  • 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

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

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  • 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.

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  • @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.

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  • 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.

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  • 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.

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  • 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!

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