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The sting in the tail of the 2% ‘pay rise’

GP practices will receive a 4.2% uplift to total funding in 2018/19, after the Government concluded its review of public sector pay rises this week.

They said this would translate to a 2% pay rise for GP partners, backdated to 1 April, and would be enough to cover practices to increase pay for salaried GPs and other staff by the same amount.

But the announcement – the first official statement from new health secretary Matt Hancock – was not received well by the BMA GP Committee, which pointed out that the 2% so-called pay rise was below the 4% recommended by the independent pay review body – that, they say, was needed ‘simply to keep services for patients running’.

GPC chair Dr Richard Vautrey said: ‘It is deeply concerning that the Government has chosen not to honour the findings of its own independent pay review body across the entire NHS, but specifically for GPs.’

DDRB recommends 4% pay rise

The Review Body on Doctors’ and Dentists’ Remuneration was emphatic in its recommendation that GPs must receive a higher pay award than the 2% it recommended across doctor and dentist specialists to improve retention.

It listed a number of ongoing pressures on GP partners, including:

  • Changes to their role and demand increase ‘as a result of the greater integration of healthcare with social care’;
  • The ‘increasing demands posed by a rising and an ageing population with more complex needs’;
  • The ‘increasing regulatory and administrative burden of running practices’
  • A ‘decreasing willingness’ on the part of younger GPs ‘to work the number of sessions their predecessors worked’, and their tendency to ‘prefer salaried employment to practice ownership’; and
  • The ‘fact that average gross earnings for [GPs], both contracted and salaried, were lower in nominal terms in 2015-16 than in 2006-07’.

The DDRB report concluded: [W]e believe that if sufficient number of GMPs are either to be recruited from overseas or encouraged to remain in the service longer than they otherwise would have done, a pay response is required now. Such a response needs to be significant and go beyond our recommended base increase for the pay remit group as a whole.’

It recommended that GPs should receive an additional 2% pay increase, above and beyond the minimum 2% rise recommended for the doctor profession as a whole.

However, the Government’s statement took a different approach to the same problem.

Mr Hancock said: ‘GPs face a significant challenge in numbers and we need to recruit large numbers over a short period, meaning any pay rise needs to be balanced against our aim for a growing number of practitioners.’

Dr Vautrey was scathing in his analysis of the stance: ‘For the new secretary of state to commit, only last week, to addressing the workforce crisis in general practice and raise hopes of investment in primary care, to now dash those hopes, will signal to dedicated GPs and their staff that they are not valued.’

GP accountant Bob Senior, head of the medical services team at RSM and chair of the Association of Independent Specialist Medical Accountants (AISMA), said the uplift would not ‘do much to help with recruitment nor retention’.

He said: ‘Even if it did translate to a 2% increase in practice profits – and I don’t know if it will, with inflation running at 3% and all of the added cost pressures – I wouldn’t say it is adequate.

‘I doubt there are many GPs who thought that it would be a big increase but they will be disappointed that the Government isn’t putting the extra £20bn promised for the NHS into general practice.’

1% extra funding uplift dependent on contract reform

Thrown in as an added bonus, the Government said GPs would be getting an extra 1% pay rise from April 2019, if they agree to the contract reforms that are currently under discussion (including the partnership model review, sweeping QOF changes, and a move to a funding model enabling ‘digital-first’ general practice).

When pushed to explain the meaning of this – would GPs get a maximum 1% pay rise next year? Just like during the years of austerity public sector pay caps? The Department of Health and Social Care explained that no, this would go into the contract baseline, and form the starting point from which next year’s uplift negotiations would begin.

A Department of Health spokesperson told Pulse that GPs are getting the standard 1% pay lift this year and the extra 1% backdated to April 2018.

The other 1% on top of that is conditional on agreement to a multi-year contract. If that is agreed, the pay award for 2019/20 will start from that baseline figure – 3% more than 2017/18. In effect, this will be very minimum they will receive.

Whether this 1% extra incentive will mean much for GPs is another matter, but it does make clear the importance the Government is putting on contract reform.

Mr Senior said: ‘I think there are likely to be bits in there that the GPs won’t like – otherwise the Government wouldn’t be taking this approach.’

In numbers – the Government’s GP pay announcement

  • Total GP funding uplift rises from the 3.4% provisional uplift announced in April to 4.2%.
  • An additional 1% uplift to the contract baseline to be applied from April 2019, subject to contract reform agreement.
  • The DHSC claims this translates to a 2% pay uplift for GP partners – ‘worth £2,000 per year to a GP contractor with a median taxable income of £100,000’ and ‘around £1,052 for a salaried GP with a median taxable income of £52,600’.
  • Minimum and maximum pay scales for salaried GPs will rise by 2% from 1 October.
  • The GP trainer grant and GP appraiser fees will be increased by 3% from 1 October.

Source: Department of Health and Social Care