New pay transparency rules force GPs to cut back on hours

GPs are reducing their hours in order to remain under the new NHS earning limits that require them to publicly declare their income from next month, the BMA has revealed.

(Picture: John Lamb/Getty Images)
(Picture: John Lamb/Getty Images)

Under regulations that took effect from 1 October, GPs with more than £150,000 in NHS earnings in the 2019/20 financial year are required to declare this income by 12 November. This is now a contractual requirement and NHS England said earlier this month that a list of GPs earning over this limit will be made public before the end of the year.

New BMA guidance on pay transparency published last week says the rules 'will potentially increase acts of aggression and abuse toward GPs and practices' and highlights that the association has 'received reports of GPs reducing their hours to remain under the threshold' for future years.

The guidance makes clear that the new regulations only apply to partners and locum GPs. Salaried GPs will not be required to declare their income, even if they are above the threshold, the BMA said.

The BMA advises GPs to 'carefully consider' the implications before they self declare, warning that by submitting their data they will be consenting to it being made public.

Breach of contract

However, after seeking legal advice, it also warns that those GPs who do not declare earnings above the threshold would effectively put their practice in breach of its contract.

'Any practice held in breach would be subject to the normal breach procedures outlined in paragraphs 70, 72 and 73 in the GMS regulations,' the guidance adds.

These procedures could involve practices receiving breach or remedial notices and lead to sanctions being applied.

The GP committee is currently seeking formal approval from the BMA council for a ballot on industrial action in response to the government's decision to only apply pay transparency rules to general practice. Action could include boycotting the process of declaring earnings.

At its meeting last week the committee voted to provide 'full support to protect and defend any constituent GPs who refuse to engage or comply with the unreasonable contractual impositions' related to pay transparency.

The BMA initially agreed to GPs declaring their income as part of the five-year contract deal on the understanding that other professions, including pharmacists, dentists and consultants, would also be required to publish details of their earnings.

Increased risk of abuse

In the latest guidance the BMA said that, as it did not agree to the amendment to regulations, it considers the regulations 'to have been imposed on the profession and in breach of the original agreement'.

The guidance added: 'It provides no benefit to GPs or their patients, but will potentially increase acts of aggression and abuse toward GPs and practices. It will be damaging to morale among the profession and is wholly counterproductive in terms of the ability to recruit and retain GPs.'

The reporting process is now an annual requirement, with the income threshold rising by £3,000 a year and the deadline for submitting information moving to 30 April - with a declaration required by that deadline for the financial year that ended around 13 months earlier.

For the 2020/21 financial year, for example, GPs and practice staff earning over £153,000 have until 30 April 2022 to report; and for 2021/22, those earning over £156,000 have until 30 April 2023 to report.

After this year, details of those earning more than these limits will be made publicly available each summer, NHS England said.

NHS earnings includes income partners or locum GPs earn from practices, along with any other income they receive from NHS salaried roles. It has been defined as what would be treated as NHS income under the NHS Pension Scheme.

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