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moneys2January 20 2016

The Department of Health has said the NHS should make better use of its £45 billion pay bill, and apportion pay increases more effectively.

In its written evidence to the Review Body on Doctors’ and Dentists’ Remuneration (DDRB) for the 2016-17 pay round, the Department has said that it does not believe there is currently the evidence to support the targeting of a 1% pay award on an occupational or regional basis.

“Distributing a 1% award in this way will not resolve or improve recruitment, retention or motivation for medical staff,” it said. “Although the government has provided sufficient funding across the public sector to fund a pay award at an average of 1% in each of the four years from 2016-17, the NHS must make better use of its £45 billion pay bill.”

The DoH submission also calls on NHS employers to look carefully at the ‘total reward’ offer and “how the pay and non-pay benefits employers can offer locally could help them recruit and retain the staff they need. We want NHS Employers and NHS trades unions to work together, in a balanced and fair way to support new ways of working as identified in the Five Year Forward View and which help support the delivery seven day services.”

In terms of contract reform for general medical practitioners, the Department notes that the average GP income before tax fell 3.1% from £105,100 in 2012-13 to £101,900 in 2013-14. In addition, total investment in general practice, taking inflation into account, had been on a declining trend from 2005-06 to 2012-13.

However, “the last two years’ data both show a real increase in expenditure. Total real expenditure in 2014-15 was 18.9% higher than 2003-04 levels (representing average real growth of 1.7% per year).” This has also been reflected in spend per person: “Real expenditure per head in 2014-15 was 9.3% higher than 2003-04 levels (representing average real growth of 0.95% per year).”

Other aspects taken into consideration in the DoH submission include:

  • data from the annual GP Worklife survey noting that GPs reported increased workloads a contributing most to stress levels, and that 45.4% of respondents were satisfied with their remuneration while 30.8% expressed dissatisfaction in this area;
  • the general direction of the NHS Five Year Forward View;
  • investment through the Primary Care Transformation Fund of £1 billion over four years;
  • the commitment to increasing the primary and community workforce by at least 10,000, including 5,000 more GPs, by 2020;
  • action being taken to reduce bureaucracy;
  • the introduction of a new voluntary contract for GP federations or practices covering populations of at least 30,000 patients.

Having made these points, the DoH submission points out that it has asked the DDRB to consider how an overall pay uplift of an average of 1% could be applied to improve recruitment and retention. “However, having carefully considered the case for targeting the pay award to support recruitment and retention, following the remit from the Chief Secretary to the Treasury, we do not consider that there is a strong case for targeting in 2016-17.”

Other aspects it asks the DDRB to note are that:

  • it should consider the impact on patient services of applying any differential uplift to GP contracts;
  • there is a lack of robust data on vacancy rates within general practice; and
  • “GP practices are independent businesses and the Review Body will also want to take into account the ability of practices to decide how to apportion any uplift and that this might not support recruitment and retention.”

Contract changes being introduced from April 2016 will require practices to publish the average earnings derived from the GP contract for GPs working in the practice.

Links:

DoH Information for the DDRB: pay round 2016 to 2017

The Review Body on Doctors’ and Dentists’ Remuneration (DDRB) Review for 2016 - Written evidence

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