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GPs asked to make more efficiencies - but how?

Bosses claim GP workload has fallen over the past decade, finds Sofia Lind

NHS England has said GP practices should be asked to make further efficiency savings before any funding uplift is considered for next year, in its official submission to the independent pay review body.

NHS bosses called on the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) ‘to consider what, if any, uplift is appropriate for 2016/17’ and rehashed the argument they made in last year’s submission, which said there was a concern that a funding uplift ‘would not necessarily’ lead to a pay rise for salaried GPs because their pay ‘may not be automatically uprated’.

They insisted GPs were different to other providers in that they are able to ‘influence the level of profits that their practices generate’ and added that they had ‘a choice to reduce expenses by creating efficiencies’.

GP practices have suffered real-terms funding cuts in eight out of the past nine years, and GP leaders warned in their DDRB submission that workforce problems ‘will continue to worsen’ and that any funding uplift should reflect the need to ‘recruit and retain’ GPs.

But according to NHS England, GP workload in terms of the number of patients cared for per full-time GP has fallen by 6.7% over the past 10 years, and managers also claimed there had been ‘a small reduction in the number of hours worked’.

However, their submission did acknowledge that there had been ‘workload increases’ for GPs linked to treating more elderly patients. The other main points of the NHS England evidence were:

  • The Government’s 1% public sector pay cap applies to everyone.
  • Unlike other groups, independent contractor GPs can increase income by taking on additional work.
  • Practices have a ‘choice’ to reduce expenses by creating efficiencies, including working at scale and sharing back-office functions, or by hiring clinical pharmacists and other support staff to absorb workload.

But GPC chair Dr Chaand Nagpaul dismissed the claim that GP practices could find further efficiencies as ‘ridiculous’.

NHS England’s evidence also acknowledged the trend for rapid increases in GPs’ indemnity costs, but added: ‘It does not necessarily follow that, just because a particular expenses category has increased in the past – or appears to be doing so currently, as in the case of professional indemnity insurance – we should automatically fund any increase relating to that going forward’.

The DDRB’s final report to ministers is expected early next year.

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Readers' comments (5)

  • The rate of GPs available for patients has in fact fallen since the last parliament.

    BRIEFING PAPER
    Number 07194, 5 October 2015

    "However, in recent years annual increases have been lower than the rate of growth in the population, hence the rate of GPs per 100,000 population has fallen since 2009."

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  • Harry Longman

    We've been demonstrating how to make huge efficiencies for four years. But for NHS England to wave this idea around in a discussion about funding really is not going to win hearts and minds. Bit of an own goal I'd say.

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  • Chaand is very good at calling things ridiculous or impossible or terrible or horrible, but doing absolutely noshing, except keeling over.

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  • We really need to dispel the idea that we can be more efficient ,without some service sacrifice.This will have consequences at emergency service provision and hospital resource waste. It is increasingly obvious to anyone who reviews their letters for outcomes,that more waste occurs from needless over investigation ,long stays and medicalisation of common ailments.

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  • The consequences of an all you can eat centrally funded system with no top up safety valve is one where the patient will be blamed for whatever lifestyle choices they make that lead to illness, or for coming to the doctor too often, or too late.
    More money is needed in the system.
    Central funded NHS with no top ups is the greatest barrier to getting this money into the system.
    We will remain beggars to government yet we chant 'save our NHS'.

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