Editorial: Why does GP pay have to be so complex?

When is a 2.29 per cent pay rise not a 2.29 per cent pay rise? Seemingly, when it relates to GP pay.

GP pay has now become so complex that it is impossible for an individual practice to tell how much its income will rise, or potentially fall, from the headline pay award.

This year, some practices will see gross core pay increase by as much as 12.5 per cent, while others' will rise just 0.7 per cent. Increases are dependent on the level of correction factor; the funding will be allocated via a mind-bogglingly complex formula and iterative process that aims to bring more practices off MPIG.

One would think that the level of detail involved in this would be in aid of ensuring everyone received a fair deal. But, complexity is no guarantee of fairness.

The Doctors' and Dentists' Review Body report said that this year's uplift should produce a 1.5 per cent rise in net income for practices. However, the allocation formula, which was decided separately by the contract negotiators, may mean few practices will see this exact figure.

We must also remember this only applies to GMS practices. The 40 per cent of practices that are PMS can enter into local negotiations only now the national award is known. The prospect of a 12.5 per cent hike in gross pay for them looks remote - NHS managers want to restrict any increase to the lowest for GMS practices, 0.7 per cent.

Therefore, it could be that the majority of UK practices see rises well below 1.5 per cent.

It seems that the answer to any problem with GP pay has been to add another layer to the process. This explains why the system is now so complex, but surely this cannot be helping. Is it time to go back to basics?

The real problem, of course, is that the government did not put enough money into the global sum in the first place, leaving the vast majority of practices reliant on MPIG.

As a direct result, we now see huge variations in core pay increases that threaten to create a whole new set of inequities to replace those that the negotiators were so keen to wipe out.

Read more opinion from the GP editorial team in the editor's blog at www.healthcarerepublic.com/blogs.

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