GPs reacted with fury last week to the government's announcement of a 3% rise without new funding to cover the costs - calling the move 'shameful and divisive', and warning it threatened to force yet more doctors out of partnership roles.
GP leaders have said the failure to increase overall funding to cover costs for practices implementing the pay rise means the government is seeking to 'sell this as a pay rise for doctors, while asking other doctors to foot the bill' - and figures obtained by GPonline offer the first insight into the scale of potential costs for practices.
An average GP practice in England could see its wage bill for salaried GPs, nurses and other practice staff rise by more than £20,000 by implementing the 3% rise, accountants at the Wesleyan Group have told GPonline.
NHS pay rise
The group - a specialist financial services mutual for doctors - estimates that the 3% rise could add around £33.5m to the cost of employing salaried GPs alone across England's 6,626 GP practices.
The bill includes the basic 3% uplift for the country's FTE salaried GP workforce plus 'on costs' including national insurance and pension costs - and comes to just over £5,000 per average practice.
Applying the rise to nurses and other practice staff, meanwhile, could cost three times this amount according to Wesleyan's estimate - taking the total bill per average practice to around £20,500.
Core GP funding is set to rise by 2.1% in 2021/22 under the five-year GP contract agreement that started in 2019 - in part to allow for a '2.1% pay and expenses increase'. But compared with the 3% rise, the scheduled increase will leave practices facing a cash shortfall worth thousands of pounds per average practice - and potentially well into five figures at larger practices.
GP service cuts
BMA executive team member Dr Krishna Kasaraneni said in an update to the profession: 'The government has said that practices will not be given additional funding on top of the 2.1% for staff already allocated for this year. This means GP partners could be faced with deciding between service cuts or being able to pay the full amount to salaried GPs.
'It is therefore not acceptable and disingenuous to speak of an uplift while refusing to provide the necessary funding. The government has completely and shamefully ignored the incredible response made by GP partners and their teams during the pandemic, suggesting that this year's pay award was to recognise the role played by other NHS workers. This will further damage GP morale and demonstrates that the government does not value general practice as it should.'
Liverpool LMC medical secretary Dr Rob Barnett told GPonline that the pay award was a 'kick in the teeth' for practices that had delivered the vast majority of COVID-19 vaccinations and endured a significant rise in workload through the pandemic.
He said partners would likely implement the increase despite the extra costs meaning their own pay could be cut. 'Most GP employers will try to be reasonable and I suspect partners will take a hit because of this,' he said.
He added that the financial impact of taking part in the COVID-19 vaccination programme was likely to vary significantly between practices and PCNs - with some worse off as a result of taking part. The unfunded pay rise could leave practices in those areas facing a double hit on income, he warned.
Doctors and accountants have also warned that the 3% increase - despite being significantly above the 1% initially proposed by the government - falls short of what is needed to keep pace with inflation, and both the BMA and other healthcare unions plan to consult staff over potential action to press for a greater uplift.
Dr Kasaraneni said: 'The BMA is hugely disappointed by the government’s announced 3% pay uplift for doctors in England. As we have come to expect from this government, yesterday’s announcement is not all that it seems. For salaried GPs, a 3% uplift is more than the 1% the government recommended at the beginning of the year and is the highest uplift they have received in many years. However, 3% does not compensate for the years of pay erosion experienced by all doctors.'
Linda Wallace, director at the Wesleyan Group, said: 'The 3% increase is somewhat of an improvement on the 1% put forward earlier in the month, but still doesn’t go far enough to reward a profession that has worked tirelessly on the frontline throughout the pandemic. In fact, the increase barely keeps pace with inflation. Any less of a salary increase would effectively be a pay cut in real-terms and put even more of a squeeze on finances.'
Announcing the pay rise earlier this month, health and social care secretary Sajid Javid said: 'We asked the independent pay review bodies for their recommendations and I’m pleased to accept them in full, with a 3% pay rise for all staff in scope, from doctors and nurses to paramedics and porters.
'We will back the NHS as we focus our efforts on getting through this pandemic and tackling the backlog of other health problems that has built up. I will continue to do everything I can to support all those in our health service who are working so tirelessly to care for patients.'