GP practices ‘may be forced’ to divert the increased funds they are receiving for pay rises to cover running costs such as expenses or overdraft repayments instead of passing it to staff, the BMA has warned.
Earlier this year, the Government accepted the recommendations of the Doctors’ and Dentists’ Remuneration Review Body (DDRB), confirming that there will be a 6% increase for GP partners, salaried GPs, and practice staff. And it said it would top up funds to enable practices to meet the extra staff costs.
However, a briefing paper drawn up by the BMA, which analyses the figures, explains why it may not be feasible for every practice to award staff the full increase.
It explains that two of the main Global Sum income elements – ‘contractor income’ and ‘other staff expenses’ – will be uplifted by 6% in total, taking the payment per weighted patient practices receive from £107.57 to £112.50. This works out as an average additional income of around £49,000 extra per practice, the BMA said.
But the union warned that the final element of the Global Sum, ‘other non-staffing expenses’, has not risen further beyond the 1.68% already added in April 2024, meaning that practices will struggle to cover running costs.
In its briefing paper, the BMA said: ‘This is highly unlikely to cover increasing practice running costs, given CPI inflation increased by 2.36% in the past year alone – and it is even more unlikely to make up for losses endured during previous years of high inflation.
‘As a result, practices may be forced to use additional funds from the DDRB uplift to cover expenses or repay overdrafts, meaning they are unable to use it all for pay rises.’
Despite the BMA GP committee England’s (GPCE) request to do so in its evidence back in February, the DDRB did not recommend an uplift to cover increased non-staffing expenses faced by practices.
The BMA also explained that additional funding is distributed on the basis of patient list size, which ‘does not correspond directly to staffing expenses’, as some practices may have fewer patients per staff member, or employ staff on higher salaries, due to seniority or needing more locum GPs.
‘These practices are at highest risk of not receiving enough additional funds through the Global Sum payment per weighted patient to afford a 6% pay rise for all their staff, including contractor and partner GPs (as intended by the DDRB),’ the BMA warned.
The union added that while the Carr-Hill formula ‘makes things inequitable’, there has been ‘very little time’ to discuss a different mechanism, such as direct staff cost reimbursement, or acquiring the necessary financial data from practices and coming to an agreement with the new Government since the general election in July.
‘Such a change to the Global Sum and distribution mechanism would take months of negotiation before agreement could be reached,’ it added.
‘Going with any other mechanism would therefore have delayed the uplift. Practices with immediate cashflow problems would have had to wait at least another six months.’
Although, previously NHS England had said it ‘firmly’ expects GP partners to award all practice staff the full 6% pay rise, the BMA clarified that only practices have the authority to decide to uplift non-GP salaried staff based on affordability.
The document added: ‘This is particularly important for those who do not receive sufficient funding to do so and cannot afford a full or more than a partial pay uplift for every salaried staff member as a result.’
It added that the GPCE ‘could not have been clearer with NHS England and the Department of Health and Social Care’ on the fact that using the same uplift implementation method ‘was going to go down very badly’ with a significant proportion of general practice staff, as well as their representative bodies.
The document added: ‘However, on behalf of the profession, GPC England needs to tread the line between maintaining the profession’s leverage as we approach the autumn and winter annual contract change negotiating window, and constructive, positive relations with the new Secretary of State for Health and Social Care and Primary Care Minister.
‘The profession will need to remain prepared to take collective action on behalf of their patients and their practices until significant progress is being made, GP and practice staff trust in policy decision making is restored and all key objectives are secured.’
This article was first published by our sister title Pulse
