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Funding squeeze forces practices to axe salaried GPs and staff

Exclusive GP practices across the country are being forced by unsustainable cost pressures to make reception staff, nurses and even salaried GPs redundant.

As many as one practice in five will lay off staff this year, with around a third of those having to shed a salaried GP post, a wide-ranging Pulse survey on workforce issues reveals.

The findings expose the toll taken on practices by financial pressures – as GPs prepare for a sixth pay squeeze in seven years – and the severity of the actions they are having to take.

The body representing medical accountants warned PMS practices were being hit particularly hard, with some forced to shed salaried GP posts to cover shortfalls in funding following contract reviews.

One GP in seven of 250 responding to the survey said they planned to make reception or administrative staff redundant, while others said they would be losing practice nurses, practice managers, specialist business managers and healthcare assistants. Of the two-thirds of GPs who said their practice employed salaried GPs, one in 10 said they would have to make at least one position redundant.

The GPC said the findings showed the extent of the strain being placed on practices, and called for more investment in primary care to protect services.

Bob Senior, chair of the Association of Independent Specialist Medical Accountants and director of medical services at RSM Tenon, said the situation was grave for many practices.

‘The practices I’ve seen who are actively making salaried doctors redundant are ones who’ve faced swingeing cuts in PMS funding.’

‘I was with a practice this morning that had just had a PMS review carried out, and it is losing £130,000 over a three-year period,’ he said.

Dr David Lloyd, a GP in Harrow, west London, said his practice would need to make five or six salaried GPs redundant at the polyclinic it runs and had already been forced to lay off nurses and administrative staff due to funding cuts.

He said: ‘It’s a tragedy, but our PCT is £55m in the red so it slashed the budget. The philosophy was that patients should go and see their own GP, but this will put more strain on A&E – which will see patients at a much higher cost.’

Dr Jonathan Evans, a GP in Wrexham, north Wales, said his practice had been forced to shed staff and replace a nurse with a healthcare assistant.

‘Our health board is considering stopping enhanced services, which would cause losses to our practice of about £25,000, which we can’t simply absorb,’ he said.

‘We’ve failed to re-advertise posts that have gone through natural wastage. We have two further staff retiring in March and we will not be re-advertising.’

Dr Rahul Shah, a GP in Knebworth, Hertfordshire, said: ‘Partners here are having to do the admin work when previously we had staff working for us. We are at the bare minimum.’

GPC negotiator Dr Beth McCarron-Nash said it was time the Government reversed the downward pressure on GP funding: ‘Practices are now feeling the real strain as costs continue to rise and profits fall.’

‘We believe real benefits could be gained by investing much more in practice premises and development to enable us to improve care for our patients rather than having to cut back on staff or services.’


Editorial: GP job losses call for unity, not division