GPs have expressed concern about their finances following the Government’s announcement of a minimum wage rise.
Ahead of his Autumn Statement today, chancellor Jeremy Hunt announced yesterday that from April next year the national living wage will increase by around 10% to £11.44.
Currently, the national living wage for those aged over 23 is £10.42, meaning the rate will rise by more than £1.02 – and will now cover 21 and 22-year-olds for the first time.
The BMA’s GP Committee in England said that while the increase is a ‘good thing’, the Government must ensure ‘struggling practices’ have adequate funding – otherwise more of them could face closure.
In its announcement, the Government said this is the ‘biggest cash increase’ to the minimum wage in over a decade and meets the manifesto pledge to ‘end low pay’.
GP partner Dr Yvette Rean said in response that the increase is ‘probably going to break a lot of us’.
‘For a small surgery it’s becoming unsustainable, had an electricity bill for £550 this month – I’m single handed,’ Dr Rean wrote in a post on X.
County Durham GP Dr Kamal Sidhu told Pulse his practice staff work ‘very hard’ and deserve to be ‘well remunerated’ – but he believes the Government is ‘creating a divide between the partners and their staff’ by not providing sufficient funding.
He said: ‘Increase of minimum wage is very welcome but it must be accompanied by increased funding for the practices. Uplift in the wages requires differentials for other staff to be maintained too.
‘Practices are already feeling a massive squeeze with increase in staff costs, energy bills and maintenance costs. This is hugely exacerbated by significant cuts in practice support and funding.
‘All we hear now from ICBs and local authorities is that there is no funding in the NHS for practices.’
Dr Pipin Singh, a GP partner in North Tyneside, said it will ‘have to be thought through how that will be funded by the Government for GP practices in the global sum’.
He told Pulse that although his practice was able to give salaried staff the recent 6% uplift, there is ‘no doubt’ this national living wage rise will ‘have an impact on finances’.
‘We’re all individual businesses – I can’t speak for other surgeries because we’re all so different – but I suspect most people will notice an impact with that,’ Dr Singh said.
Earlier this year, the Government accepted a pay review body recommendation for a 6% pay rise for NHS staff and, following negotiations with the GPC, the global sum for GP practices was increased from £102.28 to £104.73 to cover this uplift.
However, many GPs were concerned that this uplift was not adequate to pass on the 6% pay rise to all staff.
Andrew Pow, board member of the Association of Independent Specialist Medical Accountants, said the announcement will be ‘setting the alarm bells ringing in general practice, where funding is not keeping pace with wage growth’.
He said: ‘Since March 2019 the minimum wage has seen cumulative growth of around 46%, including this latest increase, compared with an increase of around 19% in global sum funding from 2019/20 through to 2023/24.
‘Many practice staff are paid the minimum wage or slightly higher and all will expect their pay to increase proportionate to the 9.8% increase. If global sum funding from April 2024 isn’t increased to take this into account, practices will be left short.’
Director of the Institute for General Practice Management (IGPM) Robyn Clark said that while she is ‘in favour’ of raising the minimum wage, GP contracts must be ‘uplifted to support this’.
‘This represents a huge cost and will also apply to the whole practice team to maintain salary differentials,’ she wrote on X.
Ms Clark also warned that without sufficient funding, implementing the minimum wage increase could ‘destabilise practices’ and ‘force them to close’ – she called on the GPC to ‘urgently’ address this in contract negotiations for next year.
Today, GPC chair Dr Katie Bramall-Stainer said: ‘Practices have already lost out on the previous minimum wage increase because the 6% funding uplift didn’t cover this.
‘Now many are struggling with extreme inflation, the rise in utilities and running costs, NHS Property Services’ extortionate charges, cost of living pay increases for other staff, alongside the overall increase in demand and lack of resource and workforce.
‘The Government must make sure that general practice has the funding it needs to keep surgeries functioning with enough staff to continue delivering patient care.’
She added: ‘Failure to do so will mean that practices will be left with no choice but to reduce staffing at a time when they are most needed in order to stay afloat, and at worse, it could see the closure of even more practices.
‘Morale is already at an all-time low, and the Government must show that it is supporting general practice and the patients who depend on its care.’
The current five-year GP contract will come to an end in March, meaning the GPC will negotiate with the Government for a new contract which could include more extensive reforms than in recent years.
However, NHS England’s primary care director told Pulse in August that they are ‘not in a position’ to negotiate a new five-year deal due to a lack of funding commitment, and the 2024/25 contract will be a ‘stepping stone’.
Earlier this month, the BMA announced that it will do an annual survey of grassroots GPs across England to help shape future contract negotiations – this year’s survey will launch at the end of the month.
if you increase salaries by 10% without funding it – surely that means you have to sack (approx) one person for every 10 people that you employ just to break even?
We’ve had several years of high minimum wage increases. over 9% this year, nearly 10% next -well above inflation.
Meanwhile our baseline goes up belatedly by 2-3% best.
This gap is making practices unsustainable.
The concept that only 44% of our baseline is staff costs must go too- many practices this is 80-90% plus, and the bit that isn’t staff pay is going up massively -like fuel.
All of the on-costs are government mandated. GP practices generate their income very largely from NHS work so haven’t got any choices here.
It is easy for government to ask employer to increase staff wages? Add 10% to global sum as well then.
I wrote to our then senior LMC bod 10 years ago about planned minimum wage increases impact on primary care in the future. My concerns were dismissed. He has since been granted his gong.
I have to disagree with Richard Greenway on just one point : that the rises are ‘well above inflation’.
He cites rises amounting to only 19% over last year, this year, and next.
Actual inflation last year was more like 30%.
But one has to agree with the rest of the comments; our staff deserve better pay; our patients deserve better service; GPs need more funding; and without a massive increase in NHS funding commensurate with the fraudulent contracts they have been handing out negligently the last 4 years, many GPs will be leaving Britain !
Majority staff in our admin team already get around £12.50 or more so the laying off 1 in 10 staff cannot be true for all practices; perhaps practices should pay more than the Tesco checkout staff rate for frontline NHS teams; some practices do so already
Always plenty money for government waste and fraud as well as wars .. but for the country , nothing available but scraps.
It all went on test and trace