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April 2018

Expenses uplift holds out promise for GPN pay rises



Agreement between the BMA and NHS England has secured an extra £256m investment for GP contracts in England, including for pay, expenses and indemnity cover.

This includes an initial 1% increase in pay and 3% uplift to expenses, ahead of any future announcement on pay by the Doctors’ and Dentists’ Remuneration Review Body (DDRB).

Last month Health Secretary Jeremy Hunt ended the public sector pay cap, which has seen salaries for nurses reduced by around 14% in real terms over recent years. However, the announcement of up to 29% increases in NHS staff pay – hedged with conditions and qualifications – was thought unlikely to filter through to nurses working for GPs.

However, the expenses uplift announced as part of the GP contract negotiations could offer real prospects for pay awards for GPNs – albeit at a modest scale.

The total investment of £256m will also see around £60m allocated to help with the rising costs of medical indemnity, and £10m to support the roll out of an e-referral service.

There will also be an important inflationary uplift to vaccination and immunisation payments, which have not increased substantially for some time.

BMA GP committee chair Richard Vautrey said that increases to GP pay were long-overdue, and that the agreed contract changes are the first step towards rectifying ‘a decade of pay cuts’.

He added that while the increased investment included within the contract was welcome, much more work was still needed to be done to improve the position of general practice in England.

He said: ‘For too long, GP pay has been in decline, despite working harder than ever to deliver more appointments in an increasingly under-pressure NHS.

‘From the outset we made it clear that after a decade of pay cuts, it is time GPs and their staff received a proper pay increase.

‘We have therefore provided strong evidence to the DDRB that doctors should be given an uplift of RPI plus 2 per cent, and we expect the Government to fund any DDRB recommendation.’

He added: ‘While this agreement alone will not resolve many of the issues facing general practice today, it builds on our progress from the last two years and provides stability to practices at a time when there is little else stable for our profession.’

He said: ‘While these changes are a step in the right direction, what is urgently needed is for the Government to provide general practice with the proper funding and support it needs to guarantee [its] future.’

Other changes to the contract for 2018-19:

  • Unplanned admissions DES to be scrapped and £157m funding returned to the global sum
  • CQC fees to be reimbursed in full
  • The sum paid per learning disabilities health check increases from £116 to £140
  • No changes to QOF but the value of the QOF point will increase
  • Four-year-olds will no longer receive seasonal flu vaccine in general practice

In Scotland, a separate GP contract comes into effect this month, with substantial variations from the contract in other UK countries. Significant changes include provision of an expanded multidisciplinary primary care team to work with practices to free up GPs to see patients who really need the input of an ‘expert medical generalist’, and the ability to transfer responsibility for some services, such as delivering vaccinations, to health boards without loss of income.

April 2018