GP trainees will receive a pay premium of £8,200 per year while on placement in GP practices, which NHS Employers said would ’ensure current level of pay is matched in the new system’.
The latest incentive to attract medical graduates to choose general practice as a career and abate the current GP workforce crisis was one of a raft of measures imposed in reforms of junior doctor’s contract last week.
Last year, BMA had claimed the Government’s initial proposals to cut the training supplement could lead to a pay cut of almost a third, or 31%.
But it is not clear how this premium will affect GP trainees relative to their other junior doctor colleagues, as it is being introduced to replace the previous GP supplement which is based on their banding plus a 45% supplement.
Last week’s imposition followed protacted negotiations and breakdowns in talks between the Government and the BMA – and two days of strike action this year.
The new contract, which will see weekdays from 7am to 9pm and Saturdays 7am to 5pm redefined as ‘plain time’ – working hours that will not attract an unsociable hours pay premium – in exchange for a 13.5% increase in base pay.
Previous NHS Employers guidance on the contract negotiations explained that ‘flexible practice premiums will be used for those in hard-to-fill training programmes’, and applies to doctors who switch to these specialties.
The NHS Employers guidance for the final imposed contract states: ‘Pay premium paid to GP trainees in practice to ensure current level of pay is matched in the new system…’
But it added that the premium ’will only be paid to doctors undertaking general practice placements as part of a general practice training programme (replacing the GP supplement)’ and will ’not be paid to those trainees whilst they are in hospital or other community placements, or to trainees on other programmes (e.g. F2) undertaking placements in general practice’.
Dr Hamed Khan, a GP in Surrey, an A&E doctor and a clinical lecturer at St George’s, University of London, said: ’I’ve heard conflicting things about this, and some trainees have calculated it and said it will be lower to them, while a few have said it will roughly amount to the same.
’The feeling is that GP will be less affected than the other specialties, but it’s uncertain and I’m not sure if people have calculated it to the extent that hospital doctors have to work out exactly how much better or worse-off they’ll be as a result.’
Dr Renee Hoenderkamp, who went on strike last month at her training practice in north London, said: ‘Our concerns are straightforward. The pay premia is “flexible” to be applied as necessary in areas of staff shortages.
’This therefore suggests that after implementation it will likely be withdrawn from areas with sufficient applicants, such as London and the South East. This will mean that trainees who are relying on the higher salary will have no option but to apply to areas of shortage which tend to be far flung… HEE will deny this currently but it is our prediction.’
Pulse approached the BMA but they were unable to comment at time of publication.
Flexible pay premia
Including general practice, the final contract offer will give premia to four specialties – including emergency medicine; oral and maxillofacial surgery; and psychiatry – as well as those undertaking academic placements.
These specialties have been most hard-pressed to fill places in recent years, and Pulse revealed this month that applications for GP training – which receives the largest premium – had fallen 6% this year.
Currently the GP Registrar (GPR) supplement for junior doctors entering a GP practice placement stands at 45% of basic pay, and without the BMA says ‘GPs would be paid on average 31% less than hospital trainees’.
When action group GP Survival highlighted this risk last autumn, it prompted the RCGP to call for a ‘cast-iron guarantee’ that plans to remove the supplement would not reduce GP trainee pay and further undermine attempts to increase recruitment.
Chair of the GPC Junior Doctors Committee, Dr Donna Tooth, has previously warned that the new pay premium system ‘would be less stable than the current supplement… and could be removed over time.’
More than one in ten training places went unfilled across England last year, despite three rounds of recruitment and an overhaul of the application method that allowed failed candidates to reapply.