NHS England has said GPs should be asked to make further efficiency savings before any funding uplift is considered for next year, in its official submission to the pay review body.
NHS bosses rejected arguments by the BMA that GPs had been ‘unfairly punished’ by low funding awards in recent years and therefore needed a higher uplift and said that GPs were different to other providers in that they can ’influence the level of profits that their practices generate’.
They called on the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) ’to carefully consider what, if any, uplift is appropriate for 2016/17’ and rehashed last year’s submission, which said that 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’ by independent contractor GPs employing them.
NHS England’s evidence to the DDRB comes after suggestions by the Department of Health that the pay award for 2016/17 should target areas of poor recruitment.
But NHS England seemed to reject that approach, arguing instead that incentives should be channelled via the ongoing 10-point workforce plan.
It said: ’We do not think it is practical for financial incentives to be targeted through the DDRB award as it is a national pay award. Instead, the GP Workforce 10 Point Plan, which is funded from the four-year Primary Care Transformation Fund, will incentivise trainee recruitment into under-doctored areas, as well as a range of targeted measures to encourage the retention and return of more experienced GPs within the workforce.’
The other main points of the NHS England evidence were:
- The Government has set a 1% public sector pay cap and this applies to everyone.
- Unlike other groups, independent contractor GPs have the ability to 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.
- Recruitment problems in some areas should not be resolved by the DDRB award as it is a national uplift.
- Salaried GP recruitment risks being hampered by an overall contractual uplift as contractors may not pass it on.
- According to NHS England, GP workload with regards to the number of patients they are caring for per full-time GP has fallen by 6.7% in the past 10 years, and NHS England also said there had been ‘a small reduction in the number of hours worked’.
- However, it did acknowledge that there had been ‘workload increases’ for GPs linked to treating more elderly patients.
The evidence also acknowledged the trend for rapid increases in GPs’ indemnity costs. However, it 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’.