The government will increase funding for general practice in England – known as the global sum – by 7% to fund pay rises for general practice nurses (GPNs) and other practice staff.
But concerns have been raised around whether this will be enough to fund the 6% rise recommended, and over a shortfall of funding for pay rises for those employed through the Additional Roles Reimbursement Scheme (ARRS).
The latest news comes after almost half of GPNs missed out on the recommended 6% pay rise last year, because of how the uplift is funded.
Last month, the Royal College of Nursing (RCN) prepared to make ‘urgent representations’ to ensure GPNs are this year given a pay rise in line with the 5.5% announced for those working in the NHS.
An internal letter from the British Medical Association (BMA) to its GP Committee (GPC) members in England, seen by our sister title Pulse, said the ‘aggregate’ rise to the global sum for GP practices will incorporate a 2.7% uplift already awarded in April.
This means the new global sum payment per weighted patient will be £112.50, up from £104.73 in 2023/24, and NHS England has ‘committed to making payments within the September 2024 practice pay run’, according to the GPC.
Last month, the government accepted the recommendations of the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), confirming that there will be a 6% increase ‘to the salary scales, pay ranges and the pay element of contracts’ for practice staff, salaried GPs, and GP partners.
NHS England later said that the uplift to the global sum is calculated to cover all practice staff, and they therefore ‘firmly expect’ GP partners to award the full 6% pay rise.
The BMA’s letter emphasised that the DDRB only covers doctors and dentists, and that ‘staff pay is a matter for employers as Independent Contractors’, regardless of the government’s ‘expectation’ for partners to honour the uplift.
It added that the uplift was ‘capitation-based, dependent upon the size of a practice’s weighted registered list’ and ‘not calculated based upon the actual staff salary costs of any practice’.
‘Staff expenses may have a general link to practice list size, as larger practices tend to have more staff, but practice staffing costs are more dependent on the clinical and administrative composition of staff, their seniority, their qualifications and expertise, and, of course, any recruitment constraints that may exist locally. Wage costs also include on-costs,’ the letter said.
It added, however, that partners ‘will want to reward staff’ during a ‘challenging time’ for general practice, and that many practice staff, and national organisations such as the Royal College of Nursing, ‘use the annual DDRB Award as a benchmark’.
A separate statement from Dr Julius Parker, deputy chair of GPC England, said: ‘Partners will want to reward all their staff for their dedication and commitment, but while some practices may receive enough to pass on a full 6% salary uplift, others won’t, forcing them to make difficult choices about what they can and can’t afford to give hardworking staff.’
This is a similar warning given by the BMA last year – when almost half of GP nursing staff went without a pay rise and around three-quarters did not receive the full uplift promised.
Today, Dr Crystal Oldman, chief executive of the Queen’s Nursing Institute (QNI), said: ‘Nurses working in general practice must benefit from this much-needed increase in resources.
The BMA’s letter also highlighted funding discrepancies for ARRS staff – employed on a scheme which primary care networks (PCNs) can use to reimburse the salaries of some staff, including nursing associates and advanced nurse practitioners.
The BMA said that for ‘ARRS staff on AfC contracts these are normally reimbursed in line with AfC salary scales’ – which this year has been uplifted by 5.5%.
In April, the total funding uplift to GP contract investment was based on a ‘planning assumption of 2% pay growth uplift to the overall ARRS’.
As such, the GPCE has said that ARRS staff would be entitled to an additional 3.5% on top of this 2%.
‘At present, the extra 3.5% will therefore be an unfunded cost pressure for the overall PCN ARRS budget,’ the letter added.
Last year, reimbursements under the ARRS were uplifted to match the AfC pay increase of 5%, but there was no overall change to the total funding available.
A spokesperson for DHSC said: ‘The government is accepting the DDRB’s pay recommendation of 6% uplift to pay. We are consulting on the implementation of DDRB for GPs and will announce further detail in due course.’
Aspects of this article were originally published in our sister titles, Pulse and The Pharmacist.
