Eligible GPs will need to declare any NHS earnings over the threshold annually. GPCE takes a view
From 1 October 2021 the GMS and PMS regulations were amended to require some GPs to self-declare their earnings. The principles of pay transparency in general practice were agreed between NHSEI and GPC England in 2019 and published in Investment and evolution – a five-year framework for GP contract reform to implement the NHS Long Term Plan.
However, the negotiation included the agreement that GPs would not be singled out. There are no similar proposals for other clinicians in the NHS, or anywhere else in the UK.
The powers in the GMS and PMS regulations contractually oblige the individuals listed below to self-declare their NHS earnings if above the NHS earnings threshold – this includes all NHS earnings and is not limited to income related to the GMS or PMS contract and services.
GPs within scope of the amended regulations
- Any single-handed contractor.
- Where the contractor is a partnership, each member of the partnership.
- Any sub-contractor (if an individual or a partnership, but not if a company).
- Any clinical services provider.
Only clinical sub-contractors are in scope, and this includes locum GPs. The regulations state that a contractor must include a requirement to disclose NHS earnings in any contract for clinical services it enters into; the same requirement is imposed on sub-contractors by the regulations. GP contractors will have to ensure that any subcontracts include the required clause.
GPs outside of the scope of the amended regulations
Individuals employed by the contractor, or employed by a sub-contractor (including where a locum GP is engaged by a third party to provide services) are NOT within scope and so do not need to declare their earnings. Therefore, salaried GPs, and those who are employed by a contractor or sub-contractor, which is a company, and the individual is not named on the contract or sub-contract, will not need to declare their earnings if above the threshold.
Company directors are also not included unless they fall under the definition above.
The threshold of NHS earnings
The threshold for the declaration of NHS earnings rises in each year of the five-year period of the framework agreement for GP contract reform as set out below.
Financial year = threshold of NHS earnings
2019/2020 = over £150,000
2020/2021 = over £153,000
2021/2022 = over £156,00
02022/2023 = over £159,000
2023/2024 = over £163,000
Information to be declared
Where contractually required to make the self-declaration, you must include your:
- job title;
- NHS earnings for the year in question (see definition of earnings section);
- the organisation(s) from which the NHS earnings were drawn.
You may have earnings from more than one contract or sub-contract and will be required to list all the organisations from which you have drawn NHS earnings for the relevant year. This is to provide transparency as to the source of NHS earnings.
NHSEI has defined a specific process for submitting the declaration of earnings. This process is not defined in the regulations.
What happens to your declaration
NHS Digital will publish the information in a national publication, listing:
- job title;
- earnings (in bands of £5,000);
- the name of the organisation where the greatest earnings were from;
- the number of other organisations that they earned from.
Through the act of self-declaration, the individual will be consenting to publication. Individuals should, therefore, carefully consider the implications before self-declaration.
Definition of earnings
The current definition of earnings is based on a GP’s pensionable income – that is based on a GP’s taxable NHS income but, from an accounting point of view, this may be too simplistic. This is likely to lead to examples of GPs in the same practice having the same income, but only some of them needing to declare it in line with the regulations.
Linking GPs earnings to taxable and pensionable profits is complicated, and the current definition of earnings will need further consideration and amendment.
GPCE believes this system is not fit-for-purpose, could directly harm individuals and adversely impact patient care.
Therefore, NHSEI must pause the process.