An LMC has advised that practices can wait to declare GP earnings over £156,000 until they receive a breach-of-contract notice.
GPs had to contractually declare income over £156,000 in 2020/21 by the end of last month – including partners, salaried and locum GPs.
NHS England published guidance on the pay transparency requirement, after consulting with the BMA’s GP Committee and the Association of Independent Specialist Medical Accountants (AISMA) late last year.
In the guidance, NHS England set out who is required to make a ‘pay transparency self-declaration’ and explained the process of making the self-declaration and how the data collected will be used.
The guidance sets the threshold for earnings for which practices have to declare GPs earning over £156,000 for 2021/22; £159,000 for 2022/23; and £163,000 for 2023/24.
The BMA said that not declaring earnings above the threshold would put a practice, not the individual (unless a single-handed GP), in breach of their contract. It also said there is no contractual requirement until a contract variation notice is served by the ICB.
It is unclear where the breach would occur for a salaried or locum GP and how this could be enforced by NHS England.
However, advice from Humberside LMC said practices could wait and only declare when they receive a breach notice.
The advice said: ‘Given this contractual clause does not place patients at risk, and is not a financial risk to [NHS England], you would have at least 28 days to then complete the declaration.
‘The LMC have told our local [NHS England] and ICB colleagues that we do not support pay transparency declaration, and that we will strongly support any GP regardless of whether they choose to participate or not.
‘However, the ultimate decision sits with every individual GP. We will continue to lobby against this via GPC and LMC conference and want to hear from any GP or practice who receives correspondence from [NHS England] or the ICB relating to this declaration.’
The guidance also said that in situations where there has been a breach of contract, but the breach is capable of remedy, a remedial notice may be issued and that the commissioner ‘must provide details of the breach’ and the steps that will need to be taken to remedy it.
The LMC said it shares the view of the BMA’s GPC that this action ‘singles GPs out’, as there are no similar proposals for other clinicians in the NHS or anywhere else in the UK.
It added: ‘This action provides no benefit to GPs or patients and will increase acts of aggression and abuse towards GPs and practices. It will be damaging to morale and wholly reduce the ability to recruit and retain GPs.’
Dr Zoe Norris, chief executive medical director of Humberside LMC, told Pulse that the guidance tried to give local GPs ‘all the possible information that they might need’.
She said: ‘I think the query that we had most of the time was “what will happen if I don’t declare”?
‘It obviously becomes difficult when NHS England haven’t made it clear. Based on other situations that resulted in a breach notice we know that there are two types of breach notice.
‘What we tried to do is give as much information as we can and then it’s up to our constituents to decide what they wish to do.
‘I said to a number of my constituents that if I was personally in that scenario then I wouldn’t be declaring my pay.
‘But that is just my personal point of view, and as an LMC it is our job to support all of our constituents regardless of what their choice is.’
NHS England failed to respond when asked by Pulse how it is going to enforce the pay transparency self-declaration process.
The BMA said that it understands NHS Pensions and HMRC data on earnings are usually anonymised before sharing with NHS Digital or NHS England, but that the union ‘cannot be sure that they cannot access identifiable data’.
The union also said that if a GP does not declare and is approached by the ICB or NHS England, they would expect evidence of why they believe the GP should declare and where they have got that information and that if this has been sourced through illegitimate means, it will be open to legal challenge.