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GPs struggling to recruit staff due to contract, accountants warn

by Anna Colivicchi
12 May 2023

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GPs are struggling to recruit and retain practice staff as a result of this year’s imposed contract failing to keep up with inflation, medical accountants have warned.

At the end of March, Government documents confirmed that the global sum would increase to £102.28 unweighted per registered patient from £99.70, an increase of 2.59%, as part of the imposed GP contract by NHS England.

The Government also recommended a 2.1% uplift for practice staff, while the minimum wage went up by short of 10% last month.

But practices have reported that they are struggling to hire staff on the new minimum wage, due to the contract uplift not keeping in line with inflation.

In a General Practice Alert State (GPAS) report, a practice in Devon said: ‘Sadly the GP contract has failed general practice and does not pay enough to recruit more staff or give the increases in salary they deserve. Burnout has become the norm.’

The report quoted another practice saying: ‘As expected and despite an increase in rate of pay, recruiting staff members is increasingly time consuming and challenging, mainly due to increase in NMW that has not been reflected in contract uplift.’

Deborah Wood, who chairs the Association of Independent Specialist Medical Accountants, said that staff cost pressures are ‘acute’ across general practice, and where the increases for the living wage are factored in, other staff remuneration must also be uplifted proportionately.

She said: ‘Add to this the issues of supply and demand for the staff needed to support patient access, the overall wages bills are escalating well beyond any funding for staff costs built into the global sum.’

She said that the combination of higher wages to recruit and maintain workforce at the right level without appropriate contract funding means that practice partners ‘will be bearing the brunt in terms of cashflow and their personal earnings, at a time when they are delivering ever more appointments and flexibility for their patients.’

She added: ‘Practice profits are being impacted by cost pressures in general due to high levels of inflation across all types of expenditure, and this has not been recognised within the below-inflation global sum uplift.’

GP accountant Andrew Pow pointed out that most incomes streams for practices have been frozen, causing income to freeze too.

He said: ‘The general news for practices is not very good news, because the only thing that has been uplifted in the core contract funding is the global sum at 2.59%.

‘So income-wise is pretty much being frozen, but on the expense side of things, the biggest cost by far for GP practices is staffing, which probably makes up 70 to 80% of a practice’s costs.

‘The minimum wage went up by just short of 10% in April and unfortunately a lot of GP staff are close to minimum wage levels including reception, administration and healthcare staff.’

He said that smaller practices have been the most affected, as there are fewer partners ‘willing to share the burden of profits going down.’

He added: ‘If there’s only two partners for example, that is what could be the breaking point for one of those partners, in which case that could be a big problem for the practice. That is why we are seeing a large number of smaller practices handing back contracts now.’

Katy Drew, primary care development manager at specialist medical accountants Sandison Easson, added: ‘The uplift for those on the NLW has the potential to reduce the differential between newer or more inexperienced staff and those with greater experience and/or responsibility. 

‘Some staff groupings may need to be reviewed and given more than the 2.1% uplift provided in the contract in order to rectify this.

‘Overall the increments given will directly impact the level of profitability as will not be funded by the uplift in the global sum.’

Practice managers and GPs will be able to hear the latest on all the important changes to the GP contract for 2023/24 at this year’s Management in Practice event in Birmingham. Register here for free.

A version of this story was first published on our sister title Pulse.