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GPs predicting 8% decrease in drawings this year

Exclusive GPs are estimating that their average drawings will decrease by 8.2% this year, with 85% predicting their income will fall due to a ‘derisory’ funding award and changes to the 2014/15 GP contract.

A Pulse survey found that GPs have had to take drastic action this year, with 15% of partners saying they have had to cut staff hours between January and April, while 7.5% of 471 respondents have had to make redundancies in that time.

It also revealed that GPs are estimating that their QOF earnings went down by more than £7,000 in 2013/14 as a result of the Department of Health’s contract imposition

GP leaders said that the findings reflect the fact that expenses have ‘skyrocketed’ at the same time that GPs have received ‘derisory’ pay awards from the Doctors and Dentists Review Body.

A similar survey by Pulse in January found that 83% of GP partners were forced to reduce their drawings in the first six months of working to the 2013/14 GP contract, with average take-home pay dropping by 7.9%.

But these new figures are on top of those reductions, and follow the changes made to the GP contract agreement for this year that had been welcomed by the GPC, and saw 40% of funding from QOF put into the global sum.

Respondents to the survey said that the DDRB funding award of 0.28%, changes to the MPIG and higher expenses mean that any benefits of the uplift have been outweighed by reductions.

However, they also said that changes to the GP contract had caused problems.

Dr Thomas Caldwell, a GP in Worcestershire, said: ‘The problem is a combination of cash flow (payment delays etc) and falling income. Money is basically being removed and then announced as new money when in fact it is simply being made harder to achieve – [such as] the removal of QOF money replaced with avoiding unplanned admissions so we can earn back the money, or actually less than the money. So much time is spent trying to manage the workload safely that strategic planning is becoming a pipe dream.’

He added: ‘We expect to need to reduce drawings by 7-8 % to maintain cash flow. Times are hard and getting worse, this is from relatively leafy Worcester.’

Dr Helen McArdle, a GP in Cumbria, said: ‘We have reduced partner drawings by 17% compared to 14 months ago, when we took an initial reduction. With all the other changes to funding we anticipate this may need to reduce further over the next year.

Dr Richard Vautrey, deputy chair of the GPC, said: ‘The reality for all practices is they have seen their expenses skyrocketing, and the derisory DDRB awards have just compounded matters, meaning they are struggling in terms of resourcing practices let alone providing resources for themselves and it is likely to be a very difficult year.’

He added that the contract changes came ‘within the financial envelope’.

He said: ‘Effectively, we weren’t negotiating around any change to the funding. It was about changes to some of the workload tickboxes. We weren’t actually making any material changes to the contract value. One of the big problems is that is isn’t just the contract funding that is the issue. We’ve actually seen a fall in the share of NHS funding going into practices.’

In its explanation for the award last year, the DDRB 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 a 1% increase in GP pay – a decision described at the time by GPC as ‘a kick in the teeth’.

NHS England was unavailable for comment.

Survey results

What change in drawings are you predicting this year (partners only)?

20%+ increase: 2 (0.5%)

10-19% increase: 4 (1%)

5-9% increase: 4 (1%)

1-4% increase: 5 (1.5%)

No change: 36 (10%)

1-4% decrease: 63 (18%)

5-9% decrease: 114 (33%)

10-19% decrease: 89 (26%)

20%+ decrease: 30 (9%)

Total answered: 347

How do you estimate your practice income from QOF has changed in 2013/14 compared with 2012/13?

20%+ increase: 2 (0.5%)

£15,001-£20,000 increase: 2 (0.5%)

£10,001-£15,000 increase: 5 (1%)

£5,001-£10,000 increase: 11 (2.5%)

£1-£5,000 increase: 17 (3.5%)

No change: 74 (18%)

£1-£5,000 decrease: 75 (18%)

£5,001-£10,000 decrease: 97 (24%)

£10,001-£15,000 decrease: 56 (14%)

£15,001-£20,000 decrease: 37 (9%)

20%+ decrease: 37 (9%)

Total answered: 412

Has your practice taken any of the following actions to reduce its expenses since January (tick all that apply):

Reduced partner drawings: 205 (44%)

Increased private work: 44 (9%)

Cut extra services offered to patients: 51 (11%)

Cut staff hours: 68 (14%)

Made administrative staff redundant: 22 (5%)

Made clinical staff redundant: 9 (2%)

Made salaried GPS redundant: 12 (3%)

Total answered: 471

About the survey: Pulse launched this survey of readers on 15 April 2014, collating responses using the SurveyMonkey tool. The 25 questions asked covered a wide range of GP topics, to avoid selection bias on any one issue. The survey was advertised to readers via our website and email newsletters, with a prize draw for a Samsung HD TV as an incentive to complete the survey. As part of the survey, respondents were asked to specify their job title. A small number of non-GPs were screened out to analyse the results for this question. These questions were answered by 417 GPs.