GP practices will receive a 0.28% increase in net funding from April, after the Government accepted advice from the pay review body that falling staff costs should be taken into account when giving GPs a 1% rise in income.
Government accepted the Review Body on Doctors’ and Dentists’ Remuneration’s recommendation of a 1% overall increase in GP income.
But the DDRB also said that a 1.4% drop in staff costs meant that only a 0.28% uplift in practice funding, administed via the global sum, was needed to achieve this increase in GP pay.
Health secretary Jeremy Hunt said: ‘We thank the Review Body on Doctors’ and Dentists’ Remuneration for its 42nd report, note its recommendations and observations, and – in respect of General Medical Practitioners (GMPs), we accept its recommendation for an increase of 1% to general medical practitioners’ income after allowing for movement in their expenses, equating to an uplift of 0.28% to the overall value of general medical services contract payments for 2014-15.’
He added: ‘The DDRB’s recommendations for a 1% consolidated rise for all staff, on top of automatic increments, are unaffordable and would risk the quality of patient care. Without a pay rise, incremental pay increases already commit nearly £1billion every year for all NHS employees and add 2% each year to the NHS pay bill for employed doctors and dentists. The DDRB proposals suggest a pay rise that would risk reductions in front line staff that could lead to unsafe patient care. It is not possible to maintain appropriate numbers of front line staff, give a general pay rise of 1% and pay for incremental progression.’
How the 1% funding rise was calculated
Income: +1% rise (contribution to uplift: +0.43%)
Staff costs: -1.4% (contribution to uplift: -0.58%)
Other costs: +2.7% (contribution to uplift: 0.43%)
TOTAL UPLIFT: 0.28%
‘The Government is therefore adopting an approach by which all staff will receive at least an additional 1% of their basic pay next year. All staff who are not eligible to receive incremental pay will be given a 1% non-consolidated payment in 2014/15. Other staff will receive an increase of at least 1% through incremental progression.’
‘It is our intention that in 2015/16 the same approach will apply and staff who are not eligible to receive incremental pay will receive a non-consolidated payment of 2% of pay, whilst other staff receive incremental progression. As this will be a two year pay award, the DDRB will not be asked to make recommendations on a pay award for employed doctors and dentists in the 2015 pay round.’
However the GPC argued that the calculation was flawed.
GPC negotiator Dr Peter Holden said: ‘This is yet again GPs subsidising the NHS out of their own pocket. That is not right – that is emotional blackmail. It is completely unacceptable. Nobody disputes the economic circumstances but if we are to have a 1% increase, unless that is manifested in a 1% increase in our pockets, and in our taxable pay, then that is not a 1% increase.’
‘I don’t understand where they get the overall staff costs falling from. My concern is that there are a large number of overheads that we are now meeting that we have never met before, or that were completely reimbursed before, and that is going to impact on things. I think we are about to see a major problem over premises reimbursement and over waste reimbursement and those items alone will take thousands off a GP’s profit line.’
GPC chair Dr Chaand Nagpaul said: ‘Today’s announcement from the Government on doctors’ pay is a kick in the teeth for GPs at a time when there is overwhelming evidence that GP workload is escalating to an unsustainable level while resources are continuing to fall in real terms.’
‘It beggars belief to suggest that an 0.28% uplift in the GP contract will translate into a 1% increase in GP pay at a time when expenses are projected to continue to accelerate. This decision fails to recognise the expanding role and workload in general practice that shows no signs of abating.’
The GPC view was supported, in part, by the DDRB itself, whose report included an attack on the formula-based approach to GP pay recommendations, which it said was ‘flawed’ and did not effectively reflect staffing costs, expenses and reimbursements, hours worked or variations in correction factor or the QOF.
The report said: ‘[W]e have serious reservations about continuing to make recommendations using the existing flawed formula-based approach. If the parties wish us to continue with making recommendations using a formula-based approach, then we believe that they should: …agree appropriate coefficients to represent staff costs;… provide a comprehensive list of all expenses and reimbursements;… consider how we should take account of variations in correction factor payments and scores against QOF; [and] provide data on the distribution of the number of hours worked, including the mean and median.’
A Department of Health spokesperson said: ‘We are committed to investing in primary care and as part of our ambitious changes to the GP contract there will be a reduction of more than a third of the QOF, allowing money GPs currently earn from these targets to be pumped in to overall primary care budgets and a new enhanced service.’