DDRB’s 6% pay uplift recommendation for GP partners ‘not enough’, says GPC

The doctors’ pay review body has recommended a 6% uplift for all GPs, including both salaried and partners, and practice staff – but this is ‘not enough to address the erosion’ of general practice funding, the BMA’s GP committee has said.

Yesterday, chancellor Rachel Reeves confirmed that the Government has accepted ‘in full’ the recommendations of the ‘independent pay review bodies’.

The Review Body on Doctors’ and Dentists’ Remuneration (DDRB) only makes recommendations on pay increases and not total funding uplift received by practices.

It is not clear what the final practice funding uplift will be, over and above the previous 1.9% awarded via the contract imposition earlier this year.

The BMA’s GP Committee England has said that whatever the funding uplift will be, the DDRB’s recommendation will not be enough to alleviate practices’ financial problems.

The DDRB report said: ‘We recommend a 6% increase to the salary scales, pay ranges and the pay element of contracts from 1 April 2024.

‘This applies to: consultants; SAS doctors and dentists; salaried dentists, including those working in Community Dental Services and the Public Dental Service; contractor general medical practitioners; salaried GP pay ranges; and the pay element of dental contracts. This applies to all the nations of the UK.’

This recommendation covers England, Wales, Scotland, and Northern Ireland.

The report also urged the Government to ensure that uplifts are ‘sufficient for the full value’ of these recommendations ‘to be reflected in earnings for contractor GPs at typical general practices’.

It shed doubt on whether this has been the case in previous years, suggesting that ‘current arrangements’ may not have ‘taken sufficient account’ of high inflation.

On top of the 6% uplift, GP trainees and other doctors in training will receive an additional £1,000 ‘non consolidated’ payment.

In an update to GPs last night, the BMA’s GP Committee England wrote: ‘A 6% [pay] uplift has been announced for GP contractors, salaried GPs and all employed practice staff.

‘This is inclusive of the previous 1.9% awarded via the contract imposition earlier this year, i.e. the award supplements an additional 4.1% on top of the existing 1.9%.’

GPCE chair Dr Katie Bramall-Stainer argued that the uplift is ‘not enough to address the erosion’ of general practice funding.

She said: ‘The profession is aware this is not enough to address the erosion of funding for general practice.’

‘While the news that the chancellor has agreed to the DDRB recommendation in full is to be welcomed, the announcement will not pause the closures of GP surgeries, reduce the inexorable workload transfer onto general practice from all parts of the wider system, and will not get thousands of under-employed GPs into practice roles,’ Dr Bramall-Stainer added.

BMA sessional GP committee chair Dr Mark Steggles said that a 6% uplift does not ‘meaningfully address’ pay erosion for salaried GPs, which ‘stood at up to 25% between 2008/9 and 2022/23’.

He said: ‘Things have never been harder for GPs – underfunding across the system means partners are seriously struggling to pay or hire the extra staff they need.

‘It’s, therefore, imperative that the 6% uplift is fully funded, including oncosts, by each nation’s Government to ensure that contractors are enabled to pass on the award in full and without delay.’

The DDRB report, which made a recommendation on GP partner pay for the first time in five years, said partners ‘strongly expressed’ the ‘significant’ cost increases they have faced over the last two years, which they said ‘has not been matched’ by NHS funding increases.

Since GP earnings data is currently only available up until 2021/22, the DDRB said it was unable to determine whether there has been a ‘sufficient’ uplift to cover expenses.

The pay review body also highlighted a change in how it makes its recommendations, highlighting that the exact value of a funding uplift is now determined by negotiations between the Government and GP representatives.

It said: ‘Until 2014, the DDRB made recommendations on the size of increased contract payments, such that it generated income growth of a particular value after accounting for any change in expenses faced by contractors.

‘However, the quality and timeliness of data for net incomes and expenses meant that often the actual changes in net incomes did not match those intended by the DDRB.

‘As a result, the DDRB stopped making recommendations in this way and started to make recommendations on the desired change in net incomes leaving the parties to discuss/negotiate/agree the appropriate increase in contract payments after taking account of the expenses faced by contractors.’

However, the report highlighted that those parties ‘have been unable to agree a robust methodology’ for setting expenses, which ‘takes appropriate account’ of changes to the costs that GP partners face.

‘We would urge governments to look for a better way of addressing this issue, possibly as part of wider contract reform,’ the DDRB stated.

The review body invited views from the BMA on how ‘they think contract uplifts can best reflect the expenses faced by GP […] contractors’.