The BMA has defended the size of the uplift it has negotiated to allow England’s GP practices to increase staff salaries.
This comes in light of criticism by GP partners, who claimed they would need to dip into their own pockets to pass on the full recommended 6% pay rise to salaried GPs and non-ARRS staff.
The BMA said that although it has been ‘clear’ that a 6% uplift is ‘ultimately not enough’, it is ‘pleased that the additional funding advised by the DDRB will not come from cuts to services’.
And it highlighted that securing the funding via the global sum meant it was secured as recurrent funding for future years.
‘This uplift is a step in the right direction and we look forward to working with the Government and NHS England in the coming months to find a long-term solution to addressing sub-inflationary resource in general practice,’ a spokesperson said.
The BMA also went some way further to explain the calculations used and said the money, which is backdated to 1 April, should land in GP practices’ accounts this month.
The global sum has been increased for 2022/23 by £2.45, from £102.28 to £104.73. This accounted for a 3.9% uplift to staffing expenses, which is on top of a 2.1% uplift earlier in the year – together this totalled a global sum increase of £233.14m.
But, as less than half of the global sum goes towards staff expenses, the 6% uplift is applied only to this portion of GP funding.
The update said: ‘The GP contract is notionally divided into three elements: GP contractor income, other staff expenses and other expenses.
‘As part of the five-year contract investment framework, the other staff expenses element was agreed to be 44% of global sum (GS), and NHS England have agreed to apply the 6% uplift to this part of GS, as this reflects the NHS income practices receive to cover these costs.
‘NHS England has confirmed that this element of funding is calculated to contribute to both the costs of salary, and on-costs, such as employers’ national insurance contributions, employers’ superannuation payments – into their employees’ pensions – and other staff benefits.’
The GPCE has also confirmed that it was successful in achieving a 6% uplift for the trainers’ grant, even though this did not form part of the DDRB’s recommendation for a pay rise.
The BMA’s update admitted: ‘This supplementary uplift is being paid via the global sum and is not, therefore, tailored to the individual staff expenses of each practice. These will be dependent on their own staffing structures.
‘There is no England-wide GP contractual option that allows an individualised practice uplift; however, increasing investment in global sum is a key GPCE policy, which ensures this in-year uplift is recurrent and locked-in for future years.’
But it added: ‘GPCE believes the decision to further uplift this year’s GMS global sum, providing an additional contribution towards practice staff costs, is helpful: we know investment in staff is a key priority for GP contractors.
‘This is the last year of the agreed 2019/24 contract investment framework, and the first in which a supplementary uplift has been agreed in-year.’
However, some GPs still questioned whether the uplift goes far enough.
Dr Michael Mullineux, a GP partner in Berkshire, told Pulse he thinks the assumption that 44% of the global sum payment goes towards staff expenses is ‘incorrect’ and as such the 6% pay rise is not ‘adequately funded’.
He said: ‘Although we run quite a tight ship, according to our accountants, with quite good cost controls, the reality is it’s about a third less than the funding required to give all our staff a 6% increase.
‘That is the bottom line. I think they’ve grossly underestimated the amount allocated.’
He added that his practice ‘will be paying the 6%, but it isn’t adequately funded’.
‘It’s an expedient that we have to follow, but as always happens it comes down to the partners funding out of their own pockets.’
Lancashire and Cumbria LMCs chief executive Dr Adam Janjua said that, having done the calculations for his own practice, it is ‘very clear that the amount coming in does not cover all practice staff getting a complete 6% pay rise’.
In an update to local practices, circulated yesterday, he said: ‘At a time when partners are having to cut their earnings to levels (in some practices) that are dangerously close to a salaried GPs earning – I can’t in good conscience recommend that they give all staff 6% if it eats up partner income once they have used up the full incoming amount.’
LMC chief Dr Janjua has advised his local practices to pass on the 6% uplift to all salaried GPs, but said that uplifts for other staff ‘are at the discretion of the practice management’.
‘But we’d strongly encourage practice to pass on the full amount of incoming money and try and get staff as close to the suggested percentage of increase as possible. This will involve some difficult conversations with staff, but practice viability is paramount,’ he added.
Medical secretary at YORLMC Dr Brian McGregor told practices that the global sum uplift is ‘not perfect as we are using a capitation based payment and practices will have different levels of staffing’.
But he said the BMA’s economists ‘believe the uplift will cover the pay rise and on-cost in the vast majority of practices’.
A DHSC spokesperson said: ‘We are hugely grateful to GPs and their teams for the work they do.
‘Working closely with the British Medical Association, we accepted the Review Body on Doctors’ and Dentists’ Remuneration’s recommendation in full to give salaried general practice staff a 6% pay rise.
‘The GP contract has now been uplifted which means salaried general practice staff, including salaried GPs, will receive their pay rise this month, backdated to April.’
GP partners are bound by the five-year contract and are excluded from the salary uplift.
Although some salaried GP contracts may not explicitly link to annual DDRB awards, the BMA has said it encourages ‘practices to pass on the uplift they receive for the purpose it is intended’.
In Scotland, a BMA survey found that the 6% pay rise for all doctors, including GPs but excluding juniors, means Scottish GPs are ‘more likely to leave the NHS’.