Exclusive A quarter of GP practices are planning staff redundancies in the wake of a new contract deal that accountants predict will deliver five-figure cuts in practice profits, a Pulse survey reveals.
A snapshot poll of 100 practices following last week's deal also found the sixth pay freeze in seven years has led two-thirds to consider freezing staff pay, with many GP partners no longer willing to take the entire financial hit in their personal pay packet. Others plan to cut back on patient services and reduce their number of appointments, even though ministers are hoping the agreement will improve access.
The GP contract deal for 2012/13 announced last week saw a 0.5% uplift for both GMS and PMS practices – delivered by raising the value of each QOF point from £130.51 to £133.76 – to help meet the costs of inflation and enable practices to give staff on salaries of £21,000 or less a £250 pay rise.
But Rosemary Smith, senior partner with RS Medical Accountancy, predicted rising practice expenses would easily outstrip the modest uplift. Her estimates suggest GMS practices could see an average cut in funding after expenses of 2.14%, or £9,220, while PMS practices could see an average fall of 2.04% – £10,341.
Ms Smith said the falls would inevitably force GPs to look again at efficiency savings, as they struggled to balance the books: ‘When you have a freeze like this for so many years, in the end something has to give.'
Pulse's survey found while nine out of 10 GP practices are again looking at reducing partners' drawings, many are also being forced to look at other options, with 62% considering freezing staff pay, 28% stopping unfunded patient services, 24% making staff redundant and 14% reducing appointments.
Dr Niti Pall, a GP in Birmingham, said: ‘For three years we've seen a year-on-year reduction in GP income. We need to have a good look at what we deliver and how we deliver it. My practice will be looking at how we can adapt the skill mix without reducing the level of service.'
Dr Caroline Chill, a GP in Raynes Park, south-west London, said: ‘Up to now we have given our staff rises in line with inflation, but given this contract we will have to reconsider that – simply because it will not be able to continue.'
Pulse's poll found GPs divided over the deal. Some 24% praised the GPC's handling of the talks while 46% were critical. But the wide-ranging agreement – which also included relaxation of practice boundaries, raised QOF thresholds and GP pay being linked to how frequently their patients visit A&E – was hailed by GPC negotiators as ‘the best possible agreement' in the circumstances.
Dr Richard Vautrey, GPC deputy chair, said: ‘Everyone in the NHS knows what pressure we are under. Despite this we have secured new money in the contract, although we know that all practices will still have to face difficult choices.'
Health secretary Andrew Lansley welcomed ‘the BMA's commitment to delivering better care while there is a continuing freeze in GP pay'.
A Department of Health spokesperson insisted efficiency measures should not affect patient care: ‘NHS organisations should not be cutting services. Practices should consider how to be more efficient.'
