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GP practices to receive 0.28% funding uplift from April

GP practices will receive a 0.28% increase in net funding from April, after the Government accepted advice from the pay review body that falling staff costs should be taken into account when giving GPs a 1% rise in income.

Government accepted the Review Body on Doctors’ and Dentists’ Remuneration’s recommendation of a 1% overall increase in GP income.

But the DDRB also 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 this increase in GP pay.

Health secretary Jeremy Hunt said: ‘We thank the Review Body on Doctors’ and Dentists’ Remuneration for its 42nd report, note its recommendations and observations, and - in respect of General Medical Practitioners (GMPs), we accept its recommendation for an increase of 1% to general medical practitioners’ income after allowing for movement in their expenses, equating to an uplift of 0.28% to the overall value of general medical services contract payments for 2014-15.’

He added: ‘The DDRB’s recommendations for a 1% consolidated rise for all staff, on top of automatic increments, are unaffordable and would risk the quality of patient care. Without a pay rise, incremental pay increases already commit nearly £1billion every year for all NHS employees and add 2% each year to the NHS pay bill for employed doctors and dentists. The DDRB proposals suggest a pay rise that would risk reductions in front line staff that could lead to unsafe patient care. It is not possible to maintain appropriate numbers of front line staff, give a general pay rise of 1% and pay for incremental progression.’

How the 1% funding rise was calculated

Income: +1% rise (contribution to uplift: +0.43%)

Staff costs: -1.4% (contribution to uplift: -0.58%)

Other costs: +2.7% (contribution to uplift: 0.43%)

TOTAL UPLIFT: 0.28%

Source: DDRB

‘The Government is therefore adopting an approach by which all staff will receive at least an additional 1% of their basic pay next year. All staff who are not eligible to receive incremental pay will be given a 1% non-consolidated payment in 2014/15. Other staff will receive an increase of at least 1% through incremental progression.’

‘It is our intention that in 2015/16 the same approach will apply and staff who are not eligible to receive incremental pay will receive a non-consolidated payment of 2% of pay, whilst other staff receive incremental progression. As this will be a two year pay award, the DDRB will not be asked to make recommendations on a pay award for employed doctors and dentists in the 2015 pay round.’

However the GPC argued that the calculation was flawed.

GPC negotiator Dr Peter Holden said: ‘This is yet again GPs subsidising the NHS out of their own pocket. That is not right – that is emotional blackmail. It is completely unacceptable. Nobody disputes the economic circumstances but if we are to have a 1% increase, unless that is manifested in a 1% increase in our pockets, and in our taxable pay, then that is not a 1% increase.’

‘I don’t understand where they get the overall staff costs falling from. My concern is that there are a large number of overheads that we are now meeting that we have never met before, or that were completely reimbursed before, and that is going to impact on things. I think we are about to see a major problem over premises reimbursement and over waste reimbursement and those items alone will take thousands off a GP’s profit line.’

GPC chair Dr Chaand Nagpaul said: ‘Today’s announcement from the Government on doctors’ pay is a kick in the teeth for GPs at a time when there is overwhelming evidence that GP workload is escalating to an unsustainable level while resources are continuing to fall in real terms.’

‘It beggars belief to suggest that an 0.28% uplift in the GP contract will translate into a 1% increase in GP pay at a time when expenses are projected to continue to accelerate. This decision fails to recognise the expanding role and workload in general practice that shows no signs of abating.’

The GPC view was supported, in part, by the DDRB itself, whose report included an attack on the formula-based approach to GP pay recommendations, which it said was ‘flawed’ and did not effectively reflect staffing costs, expenses and reimbursements, hours worked or variations in correction factor or the QOF.

The report said: ‘[W]e have serious reservations about continuing to make recommendations using the existing flawed formula-based approach. If the parties wish us to continue with making recommendations using a formula-based approach, then we believe that they should: …agree appropriate coefficients to represent staff costs;… provide a comprehensive list of all expenses and reimbursements;… consider how we should take account of variations in correction factor payments and scores against QOF; [and] provide data on the distribution of the number of hours worked, including the mean and median.’

A Department of Health spokesperson said: ‘We are committed to investing in primary care and as part of our ambitious changes to the GP contract there will be a reduction of more than a third of the QOF, allowing money GPs currently earn from these targets to be pumped in to overall primary care budgets and a new enhanced service.’

Related images

  • Jeremy Hunt - online


Readers' comments (68)

  • Jeremy Hunt talks about "the market" but still does not understand it!! In open markets, if you treat people/organisations like crap and pay them sub-cost for work.....they simply pull out of the market or leave the profession.
    The writing is on the wall.....NOBODY wants to be a GP anymore. Unless we start "waterboarding orange-suited GP trainees" we simply won't have a GP service anymore. You can't make people choose GP anymore even if you can successfully bully those who unfortunately made the mistake of entering GP land and who are too far down the road to turn back or change career.
    Hunt's remedial understanding of market forces combined with his disciplinarian view of the public sector will trigger this collapse. It is like the Titanic...sinking will be a mathematical certainty.

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  • There's been a drop in staff costs? In which universe?

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  • My friends in IT industry were very sad that their rise in pay has dropped to the lowest in living memory last year to 15%!!! Many of them had 50 to 100% increases in the boom years along with Employee stock options.
    Given many of them did worse than those of us who did medicine it seems after working longer and harder and saving lives we should be rejoicing at 0.28% increase.
    Of course we chose the bed to lay on but seems very uncomfortable of late and time to leave.

    Time to leave the NHS.

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  • staff costs can only have fallen if staff are laid off,the man is an idiot and the DDRB stuffed full of cronies,bring on labour they may be incompetent but at least they support the NHS

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  • When General Practice does collapse, the public can thank The Daily Mail and Jeremy Hunt, though Hunt will have "cunningly" moved on by then to another department.

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  • I'm a trainee who is quitting. Joining GP training was the worst mistake I have made - you get treated like crap by govt, patients and patronised to death by hospital workers who think they're superior because they can hide behind each other and their stupid protocols. Time to do something for myself. I feel badly let down.

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  • The point is will it collapse? the reality is we're trapped by our own professionalism and self worth. We strive to do our best even if it means regularly shooting ourselves in both feet.

    I've seen recent arguments where senior partners are happy to take 40% pay cut rather then reduce costs - they can afford the pay cut. Junior partners who cannot afford this are forced to argue for cuts. Its a horrible situation, there are so many conflicts within the GP community that it will be relatively easy for the super surgeries to pick us off one at a time.

    Of course the quality of care will deteriorate but it's never been about that.

    The solutions are out there, cutting costs short term is one, talking to patient groups making them understand the reality on the ground and transferring any costs - stopping anything that we subsidize from phlebotomy for near patient testing to number of appointments. Also if you have less then 3 FTE doctors you really as a matter of urgency must talk to the largest rival practice in the area and start some sort of federating plan. NHS England really wants to see small surgeries collapse and allow some form of super surgery to exist ( which will magically solve all problems). NHS England really do not care who owns these large supersurgeries - Hurley, Virgin or the existing local surgeries. Hence if you're small get friendly with your rivals and start talking - for your futures.

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  • IF and I mean if there has been a drop in staff costs, it's because the older staff (on better wages through time served) who have been beaten with the same stick of very small pay increases over the past few years have had enough and left! This means we are recruiting inexperienced younger staff willing to take on this type of work for very little pay rather than be out of work. This lack of experience is partly to blame for some of the problems we are seeing in primary care. Whereas before staff could give sound advice to patients, they now have to pass much more on to the GP's to answer and because the patients are wanting an instant reply, they don't wait and end up sitting in A&E!

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  • Sadly the trainee is right. I am approaching voluntary retirement a few years early. I do not regret going into general practice but in the last 10 years the overall environment has been pushed into unacceptable territory by external forces, ultimately controlled by successive governments who continue to fail us. As a result I myself and almost all the colleagues I have spoken to would no longer recommend a career in General Practice. A career as a GP fails the friends and family test hands down. The saddest thing is that It is very very bad for patients, ie everybody.

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  • The "will it collapse" arguments are rather like "the titanic is too big to sink" beliefs. Yes, us GPs act like victims and allow ourselves to be bullied. BUT, it is the lack of new GPs that WILL bring down General Practice. Once this is established, General Practice WILL collapse. It is all down to numbers.
    Those who don't understand such self-evident market dynamics need to switch from using the emotional brain centres to the logical reasoning frontal cortex.

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