The BMA has confirmed that salaried GPs are not required to declare earnings above £150k.
It also said that it is ‘unclear’ how NHS England will ‘police’ declarations and that any evidence sourced for monitoring via ‘illegitimate means’ will be ‘open to legal challenge’.
It comes as eligible GPs have been given until tomorrow (12 November) to disclose their earnings from last year if they are £150,000 or more after the annual declaration became a legal requirement last month.
Previously, it was understood that any GP who earns more than £150,000 per year in pensionable income – including partners, salaried GPs and locums – would be ‘listed by name and earnings bands’ publicly.
However, BMA guidance updated today confirmed that salaried GPs and those ‘employed by a contractor or sub-contractor’ will not need to declare their earnings if above the threshold.
It said: ‘It is not clear to us why NHSEI/DHSC has not included salaried GPs in this and they have chosen not to share their thinking on it.
‘We understand that NHSEI’s intentions were to bring this in for those who work on a “for profit” basis and do not believe that salaried GPs are able to accept additional earnings without additional work or responsibilities.’
However, the BMA said it does ‘not believe there will be many purely salaried GPs that earn above the threshold’.
The BMA said those within the scope of the amended regulations are:
- Any single-handed contractor
- Where the contractor is a partnership, each member of the partnership
- Any clinical sub-contractor including locum GPs if an individual or a partnership, but not if a company
- Any clinical services provider
The guidance added: ‘The contract regulations cannot make someone who is not party to the core contract declare their earnings.
‘However, they require the practice to include terms within any sub-contract to require the sub-contractor, an individual or the partners of a partnership, to declare their earnings.’
Any locum sub-contracted directly by a practice would therefore be subject to the disclosure requirement and if they did not comply, the practice ‘would decide how to remedy such a breach’.
The practice would be in breach of their core contract if they did not include the terms in locum agreements but if they do, they ‘will not be in breach of their core contract whether or not the locum or sub-contractor does declare their earnings’.
The BMA also said that its ‘interpretation of the regulations’ suggests that any locum GP employed by a third party and supplied to a practice will not be subject to the disclosure obligation.
It added that it believes locums set up as their own limited company are ‘treated the same as locums employed by third parties’ and therefore do not have to declare earnings.
However, it said that the regulations ‘are poorly drafted on this matter and there is some uncertainty around this issue’.
Meanwhile, the BMA guidance also said that it remains ‘unclear’ how NHS England will monitor the requirement as it is ‘not aware’ of any way it can verify GP income.
It said: ‘It is unclear to us how NHSEI will police this. We are not aware of a way that NHSEI might verify the income of those who have declared or not declared, but we cannot be sure that this is not possible.
‘We understand NHS Pensions and HMRC data on earnings are usually anonymised before sharing with NHSD/NHSEI, but we cannot be sure that they cannot access identifiable data.’
It added: ‘If a GP does not declare and is approached by the CCG or NHSEI, we would expect evidence of why they believe the GP should declare and where they have got that information. If this has been sourced through illegitimate means, it will be open to legal challenge.’
The BMA’s GP Committee for England ‘has already received reports of GPs reducing their hours to remain under the threshold’, the guidance said.
It added that the regulation only applies once practices have had their contracts varied to include the new rules, with a 14-day contract variation notice.
It said: ‘The legal advice we have received is that no practice has a contractual duty to comply with these new rules until it is served with a 14-day contract variation notice and the period of the notice has expired.’
‘Many GP practices have not received any notice of variation’, it added.
It comes as GPs were last week given until 14 November to respond to a BMA ballot asking what action they are prepared to take against NHS England’s access plan – including refusing to comply with the contractual requirement to declare earnings over £150,000.
In September, the BMA said that GPs have been ‘singled out’ and that the launch of the requirement has ‘breached’ its contract agreement with commissioners.
GP leaders have previously argued that this is an attempt to name and shame GPs that does not reflect the hours they work, and which will ultimately fuel anti-GP sentiment among the public who believe family doctors are paid too much.
GPs have been required to publish average individual net earning on their practice website since 2016/17, following a previous move to increase transparency on earnings.