Rachel Carter looks at the claims about GP salaries following the publication of earning and expenses data
GP earnings figures released at the beginning of September sparked yet more bashing of the profession. Several of the national newspapers ran stories questioning why GPs had received a ‘pay rise’ during the Covid pandemic when face-to-face care was reduced, and surgeries were ‘closed’.
The data on 2020/21 earnings and expenses information for full- and part-time GPs working in the UK do show the estimated average income for partner and salaried GPs rose significantly.
While the coverage was factually accurate, there was little explanation for the figures. Here we provide context for the Telegraph’s claims1, which were typical of the wider coverage.
‘GPs saw their earnings rise to £142,000 during the pandemic in a Covid pay boom, new data show… doctors’ incomes rose to unprecedented heights. Some of the extra money will have come from delivering the Covid vaccine rollout… patients’ groups said the increase was “extremely difficult to justify”.’
The £142,000 figure relates to the increase in income for GP partners – and the comment that this is ‘unprecedented’ does contain some truth, given that the 17% increase between 2019/20 and 2020/21 income is much higher than in previous years.
However, medical accountants have pointed out that real-terms figures, also included in NHS Digital’s dataset2, show this figure marked a return to a similar level of income to that seen in 2004/05, after a series of real-terms cuts before 2019/20.
Where the article talks about ‘extra money’ and a ‘rise’, this shows a problem with much of the reporting of these figures, which does not attempt to explain the nuances in general practice funding.
In reality, there have been only limited rises in total funding into general practice. These increases came through two routes: first, the planned contractual increase, which was around 2.3%; and second, as the Telegraph article suggests, through funding provided as part of efforts to counter Covid, including vaccination fees.
However, one of the reasons average pay is increasing is because funding is being shared by fewer GPs.
Figures from NHS Digital’s GP workforce dataset show there were 718 fewer GP partners in March 2021 than in March 2020. As a consequence, while pay rises, so does workload, which is reflected in the hugely increased work burden partners and their teams are facing.
‘During the pandemic, GPs were paid £13 per Covid vaccination, with rates rising to £15 and extra on Sundays as the crisis became more urgent. Meanwhile, the framework that normally governs their pay, linking it to how much work they do, was partially suspended. Under a deal negotiated with the BMA, GPs continued to be paid for tasks such as checks on the elderly and monitoring patients with asthma, diabetes and heart disease without having to do them.’
The article does acknowledge some of the reasons why the figures show an increase in GP income for 2020/21 – specifically the extra Covid funding practices received. It also includes a quote from BMA England GP committee chair Dr Farah Jameel explaining that practices had received ‘additional short-term and temporary emergency Covid response funding’ to support the successful delivery of the Covid vaccination programme despite the ‘huge and historic workforce shortages’.
On the QOF suspension, the reporting is accurate. But funding for the framework was income protected – which means there was no increase in funding, just that practices were able to devote more time to the priority of Covid. Admittedly, additional time could be spent on activities that did attract income – such as the vital national vaccination programme – but of course, this increased workload beyond the time saved by the suspension of the QOF.
And parts of the framework were never suspended – a quarter of QOF points still had to be achieved in the normal way. Of the 567 points available in 2020/21, 354 were income protected and 74 were awarded in full, but 139 – including those for cervical screening and flu vaccinations – were based on practice achievement for that year as normal. Practices were also still expected to deliver as much patient care as they could in areas where income was protected, such as asthma, diabetes and heart disease.
Any ‘pay rise’ is likely to be shortlived. Jenny Stone, from medical specialist RBP Chartered Accountants, told Pulse that while most clients saw an increase in 2020/21, it was ‘temporary’ and mainly due to ‘income being protected, Covid support and vaccination income, and spending less on costs such as locums in the first lockdown’. She said clients’ 2021/22 accounts show profits have stabilised, but RBP is anticipating these will fall in 2022/23.
- GPs given record pay rises in Covid pandemic. Telegraph, 1 September 2022.
- NHS Digital. GP Earnings and Expenses Estimates, 2020/21. September 2022.