Who decides on the GP funding uplift?
Ultimately the Department of Health sets the percentage uplift, signed off by the health secretary, however it is not as simple as the DH being able to determine this on its own. Because the Treasury rather than the DH controls the public purse, the DH has, more or less, to act within the remit of any caps on public sector pay that the Treasury has set out, which for the past few years has been set a 1% after several years of frozen pay.
Where does the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) come in?
The DDRB acts as an independent advisor to Government on rates of pay for doctors and dentists, but the DDRB makes its recommendation only upon instruction by Government. Once the DDRB has been given this remit, the Department of Health, NHS England, Health Education England and the BMA are invited to make evidence submissions to the DDRB.
What – except for expenses – does the DDRB take into account when making its uplift recommendation?
The full list of factors the DDRB considers are: the need to recruit, retain and motivate doctors and dentists; regional/local variations in labour markets and their effects on the recruitment and retention of doctors and dentists; the funds available to the health departments as set out in the Government’s departmental expenditure limits; the Government’s inflation target; the overall strategy that the NHS should place patients at the heart of all it does and the mechanisms by which that is to be achieved; the economic and other evidence submitted by the government, staff and professional representatives and others; and the legal obligations on the NHS, including anti-discrimination legislation regarding age, gender, race, sexual orientation, religion and belief and disability.
When does the DDRB report?
Typically not before March.
What happens after that?
After that the DH reviews the recommendation and decides whether or not to implement it. For example for 2014/15, the DH accepted a DDRB recommendation of a 0.28% uplift, but for 2013/14 the DH rejected a recommendation for a 2.29% pay rise to cover expenses and said practices would only receive a 1.32% uplift in funding.