As part of the 2015/16 contract deal in England, GPs will have to publish the average earnings of all partners and salaried doctors working at the practice by April 2016 on their practice website. This applies to contractual income from NHS England, CCGs and local authorities. While the plans are being sold as a vital aid in increasing transparency, there are worries that they will backfire on GPs, with the figures being meaningless to the public and time-consuming to produce. Critics also suggest it will make recruitment more difficult for under-doctored areas where the information will reveal just how low salaries are at GP practices.
Q What exactly do we have to publish?
Practices must publish the mean earnings for all GPs in their practice as well as stating the number of full and part-time GPs. Earnings relate to income from NHS England, CCGs and local authorities and public health services for the provision of GP services that relate to the contract or have been nationally determined. Earnings reported are before tax, national insurance and employee pension contributions, and for partners the figures should be net of expenses.
Q When do we have to publish, and which accounting year should it relate to?
The publication relates to the 2014/15 financial year and should be on the practice website by 31 March 2016. It should be updated annually. If patients do not have internet access and ask to see this information, practices are required to provide it either on paper or to show the patient on a practice computer.
Q What happens if we refuse or forget to publish this information? How will this be monitored?
Practices will be in breach of their contract if they do not do this. It will be monitored by eDeclaration although NHS England, or CCGs that have taken on contract management through co-commissioning have the power to request further evidence if they believe a practice is breaching its contract.
Q The calculation might be complex. Will a guesstimate suffice?
No. A proper calculation should be done – a guesstimate is not acceptable. Detailed guidance has been produced for accountants.
Q How is this ‘mean’ of partners, salaried doctors and locums defined?
The mean GP earnings figure includes all partners (GPs who are party to the contract for at least six months in the 2014/15 financial year), salaried and locum GPs who worked full or part time in the practice (for a total of six months or more in the financial year).
Q What is not included? Does it include private income?
No, private income is not included. Practices should not include income that is not related to the nationally determined contract.
It therefore does not include premises costs, locally commissioned enhanced services that vary from area to area, locally specific CCG payments, education and training grants and most dispensing income and costs (except income for nationally determined contract items, such as flu vaccination).
Q If publishing our earnings was part of a contract negotiation, what did the GPC win for GPs?
These arrangements are part of a package of changes for 2015/16, many of which deliver improvements for practices. They are also an improvement on the plans outlined last year, which threatened the publication of individual GP earnings on a central database, which the media could have used to form a ‘league table’ of GPs.
Q Do the regulations apply to GMS, PMS and APMS practices? Do they apply to private GPs?
No, they do not apply to solely private GPs as they relate to NHS income. They apply to all GMS and PMS practices. They are intended to apply to APMS practices but this will be determined by their local contract.
Q How can practices minimise the potential for negative comments from patients or the media?
Practices should publish the information in a simple way and not embellish it with comments that might draw more attention to the publication.
Q What is likely to happen in the future? Are we heading for the publication of individual earnings?
The GPC is not considering further changes to this publication scheme, such as including individual earnings, and we expect NHS England to focus on publishing other public sector earnings.
Dr Richard Vautrey is GPC deputy chair