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Q&A: Tariff proposals for GP trainees

What are the current arrangements for paying GP trainees?

As it stands, practices are reimbursed the full salary of trainees by Local Education & Training Boards (LETBs), and previously by deaneries. They are also given a £7,600 trainer’s grant per year.

What is being proposed?

The Government said in an impact assessment at the start of the year that it wants all providers to contribute to trainees’ salaries to cover the service element of their roles. The business plan from Health Education England, released on 10 July, confirmed that it aims to introduce tariffs by April 2014 to standardise how much training practices receive for providing training, and this could take the form of charging them for part of the trainees’ salaries.

How much are the tariffs likely to be?

There is no indication as yet. However, the impact assessment said the preferred option for secondary care providers was to provide 50% funding of the trainees’ salary plus a ‘placement rate’.

Has this been proposed before?

Pulse revealed last year that the Committee of General Practice Educational Directors (COGPED) was trying to convince the Government to introduce a tariff to cover the cost of final year trainees providing service in the transitional year from three-year to four-year training. The Government also mooted plans to impose a ‘training levy’ on all practices to pay for LETBs, but it later dropped this following opposition from GPs.

What does the BMA think?

The BMA says that the plans could have a drastic effect on whether practices take on GP trainees. GPC negotiator Dr Beth McCarron-Nash says: ‘It is about their training needs, not about the service needs of their practice. They remain supernumerary. It is very different to having a salaried GP, who is an integral part of the workforce. GP trainees take holiday when they want, they go on training courses and training practices do not rely on them to service provision.’

What happens next?

It is highly likely that these tariffs will be discussed as part of the contract negotiations for junior doctors and GP registrars, in which the GPC will be represented. These negotiations are likely to begin in the autumn.

What are the wider implications of the training tariff?

Dr McCarron-Nash says that practices won’t be able to afford to continue training if a tariff is imposed on them. This could have disastrous implications for the future of workforce planning at a time when the Government is falling short its attempts to recruit 3,250 trainees a year by 2015.