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NHSE warns DDRB against recommending practice staff pay increase above 2%

by Eliza Parr
10 April 2024

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NHS England has warned the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) against recommending a GP and practice staff pay increase above 2%.

In its evidence to the pay review body, NHSE advised that any pay awards higher than the funding settlement from the Treasury will ‘put further pressure’ on the NHS budget.

This could affect ‘staffing numbers’ and delivery of NHS activity or ‘service improvements’, the national commissioner warned.

The submission stated that within the NHS settlement, ‘funding is available for a pay uplift of 2% for contractor GPs, salaried GPs and other salaried practice staff’.

In separate evidence, NHS England also said a pay rise of more than 2% for staff on Agenda for Change contracts would similarly ‘put pressure on the NHS budget’.

Since this evidence was submitted to the DDRB in February, NHS England and the Government have imposed a new GP contract for 2024/25. This has increased overall investment by 2.2%, and includes a 2% pay uplift for GPs and practice staff.

Earlier this year, the Government said it may reconsider its GP funding uplift once the DDRB makes a recommendation on GP pay, but it is not obliged to accept it in full.

This is the first time in five years that the DDRB has been asked to give a recommendation on GP partner pay following the 2019 five-year GP contract deal that had aimed for a 2% year-on-year pay increase.

In its evidence to the pay review body, NHSE said: ‘Pay awards that are higher than the levels contained in the funding settlement, if not supported by additional funding from government, will put further pressure on the NHS budget given the existing funding pressures.

‘This could impact on staffing numbers and the ability to deliver planned activity or service improvements.’

The evidence also included data on the number of GPs in the workforce by role and their income.

Average GP contractor income before tax rose by 8% from £142,000 in 2020/21 to £153,400 in 2021/22.

NHS England noted that this is ‘significantly above’ the maximum 2.1% uplift agreed, but highlighted that this is ‘due mainly to the additional funding’ provided to GP practices for the Covid-19 vaccination programme.

Average income before tax for salaried GPs in England also increased over the same period, from £64,900 to £68,000 – a jump of just under 5%.

But NHS England only included data up until 2021/22 in its DDRB submission, and a recent BMA survey suggested that GP contractor income in England has dropped by a fifth in the past year.

Meanwhile, last Friday, the Government confirmed that it will make changes to the operation of the DDRB, taking into account the views of the BMA, after reaching a pay settlement with consultants.

From next year, there will be changes to the way the body will appoint members, and the Government will not be able to ‘constrain’ its remit with reference to inflation targets and economic evidence.

The DDRB’s terms of reference will also be changed to specifically include developments in earnings over time in the context of long-term trends in the wider labour market, comparator professions, and relevant international comparators.

These changes mean that the DDRB ‘can no longer ignore the historical losses’ that doctors have suffered, the BMA said.

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