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GPs predicting 8% decrease in drawings this year

Exclusive GPs are estimating that their average drawings will decrease by 8.2% this year, with 85% predicting their income will fall due to a ‘derisory’ funding award and changes to the 2014/15 GP contract.

A Pulse survey found that GPs have had to take drastic action this year, with 15% of partners saying they have had to cut staff hours between January and April, while 7.5% of 471 respondents have had to make redundancies in that time.

It also revealed that GPs are estimating that their QOF earnings went down by more than £7,000 in 2013/14 as a result of the Department of Health’s contract imposition

GP leaders said that the findings reflect the fact that expenses have ‘skyrocketed’ at the same time that GPs have received ‘derisory’ pay awards from the Doctors and Dentists Review Body.

A similar survey by Pulse in January found that 83% of GP partners were forced to reduce their drawings in the first six months of working to the 2013/14 GP contract, with average take-home pay dropping by 7.9%.

But these new figures are on top of those reductions, and follow the changes made to the GP contract agreement for this year that had been welcomed by the GPC, and saw 40% of funding from QOF put into the global sum.

Respondents to the survey said that the DDRB funding award of 0.28%, changes to the MPIG and higher expenses mean that any benefits of the uplift have been outweighed by reductions.

However, they also said that changes to the GP contract had caused problems.

Dr Thomas Caldwell, a GP in Worcestershire, said: ‘The problem is a combination of cash flow (payment delays etc) and falling income. Money is basically being removed and then announced as new money when in fact it is simply being made harder to achieve - [such as] the removal of QOF money replaced with avoiding unplanned admissions so we can earn back the money, or actually less than the money. So much time is spent trying to manage the workload safely that strategic planning is becoming a pipe dream.’

He added: ‘We expect to need to reduce drawings by 7-8 % to maintain cash flow. Times are hard and getting worse, this is from relatively leafy Worcester.’

Dr Helen McArdle, a GP in Cumbria, said: ‘We have reduced partner drawings by 17% compared to 14 months ago, when we took an initial reduction. With all the other changes to funding we anticipate this may need to reduce further over the next year.

Dr Richard Vautrey, deputy chair of the GPC, said: ‘The reality for all practices is they have seen their expenses skyrocketing, and the derisory DDRB awards have just compounded matters, meaning they are struggling in terms of resourcing practices let alone providing resources for themselves and it is likely to be a very difficult year.’

He added that the contract changes came ‘within the financial envelope’.

He said: ‘Effectively, we weren’t negotiating around any change to the funding. It was about changes to some of the workload tickboxes. We weren’t actually making any material changes to the contract value. One of the big problems is that is isn’t just the contract funding that is the issue. We’ve actually seen a fall in the share of NHS funding going into practices.’

In its explanation for the award last year, the DDRB said that a 1.4% drop in staff costs meant that only a 0.28% uplift in practice funding, administed via the global sum, was needed to achieve a 1% increase in GP pay - a decision described at the time by GPC as ‘a kick in the teeth’.

NHS England was unavailable for comment.

Survey results

What change in drawings are you predicting this year (partners only)?

20%+ increase: 2 (0.5%)

10-19% increase: 4 (1%)

5-9% increase: 4 (1%)

1-4% increase: 5 (1.5%)

No change: 36 (10%)

1-4% decrease: 63 (18%)

5-9% decrease: 114 (33%)

10-19% decrease: 89 (26%)

20%+ decrease: 30 (9%)

Total answered: 347

How do you estimate your practice income from QOF has changed in 2013/14 compared with 2012/13?

20%+ increase: 2 (0.5%)

£15,001-£20,000 increase: 2 (0.5%)

£10,001-£15,000 increase: 5 (1%)

£5,001-£10,000 increase: 11 (2.5%)

£1-£5,000 increase: 17 (3.5%)

No change: 74 (18%)

£1-£5,000 decrease: 75 (18%)

£5,001-£10,000 decrease: 97 (24%)

£10,001-£15,000 decrease: 56 (14%)

£15,001-£20,000 decrease: 37 (9%)

20%+ decrease: 37 (9%)

Total answered: 412

Has your practice taken any of the following actions to reduce its expenses since January (tick all that apply):

Reduced partner drawings: 205 (44%)

Increased private work: 44 (9%)

Cut extra services offered to patients: 51 (11%)

Cut staff hours: 68 (14%)

Made administrative staff redundant: 22 (5%)

Made clinical staff redundant: 9 (2%)

Made salaried GPS redundant: 12 (3%)

Total answered: 471

About the survey: Pulse launched this survey of readers on 15 April 2014, collating responses using the SurveyMonkey tool. The 25 questions asked covered a wide range of GP topics, to avoid selection bias on any one issue. The survey was advertised to readers via our website and email newsletters, with a prize draw for a Samsung HD TV as an incentive to complete the survey. As part of the survey, respondents were asked to specify their job title. A small number of non-GPs were screened out to analyse the results for this question. These questions were answered by 417 GPs.

Readers' comments (22)

  • Who else would put up with this?
    Isn't it time the BMA grew some and had proper hard hitting industrial action?

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  • Actually no point in waiting for someone else to action this e.g. BMA, RCGP- they have shown their lack of ability to help us. We have to do this ourselves. We need to vote with our feet and either individually resign or with mass resignation.

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  • I have seen over the years,about firstly inability of ,we GP's to decide on some ground breaking decisive action and secondly repeatedly voting for the bodies like GPC,BMA,RCGP etc ., who in my opinion are only trying to hold on to their elected posts ,may be for some political gains in the future!!!

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  • the profession has been continually 'dumbed down' by government and media. Until they and the public appreciate what primary care achieves ie significantly cost-effective healthcare with inadequate resources and excessive and unwarranted burden due to triviality, not many of us will remain to practice.
    It needs a mass open-ended resignation, withdrawal from all unfunded work (and there's a lot of that going on).......
    Too much airy fairy worry about what patients might think of us.....well, as 10:47 says, time to grow some! It's equally about our health, our family lives.....

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  • nobody will resign and no one will go on strike. i have seen it all before and income drop is different for different practices. i kept big list in past to absorb all shocks. if there is one thing that will impact most is loss of mpig.
    there will be gp's with £70k and there will be gp with £170K to 200k profit.

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  • 44% reduce drawings
    11% reduce services to patients.

    Surely this should be the other way around. If reduction in funding does not reduce services to patients the people in charge will continue to do it - I would.

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  • The threat to resignation is probably the only solution. Is this what PlanB was back in the day?
    I'm sure our negotiators will sort it out!

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  • No OOH for 2 weeks . A+E floods . Government caves in.

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  • @Anonymous | Sessional/Locum GP | 10 June 2014 12:04pm
    "nobody will resign and no one will go on strike. i have seen it all before and income drop is different for different practices. i kept big list in past to absorb all shocks."

    Dear colleague

    Your post suggests that you were once in partnerhsip or a single-handed principal. your status is listed as a sessional GP. Did you forgo independent contractor status because of workload, stress or pay since you are still working? If you did for any of the above then it DOES support the view that GPs will retire/ emigrate/locum as this see fit. This is sensible as we cannot sacrifice our own health and sanity for the DOH which doesn't give two hoots about the NHS workforce!

    Big list sizes will only put more strain on reducing numbers of GP relative to population expansion. The writing is already on the wall for general practice and all GPs make sure they have a plan B.

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  • Actually, with increased workloads it is more than a 50% drop in income in 10 years.
    Here in NI, we used to get £ 80 for 4 consultations per patient year in 2005 [ £20 per consult translating to £ 6 take home when you factor in 40% paper work, tax , NIC etc.It is now £60 for 6+ consultations that translates to £ 3 take home per consult. This is a 50% drop in income per item.
    GPs are going bankrupt on this GPC's watch. The whole lot of them should resign as they take our money and cannot do a thing, except talk rubbish with absolutely no action.
    It is time to ballot for mass resignation. At least, there is a straight forward Eire model we can copy - it is £50 to see a GP.

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