Nursing leaders demand more funds for GP practice staff pay rise

As reported by GP Online, nursing leaders have urged for additional funding to ensure a 6% pay rise for GP practice staff, emphasizing that the current allocation is insufficient to cover the promised uplift for all salaried staff members

The RCN has called on the government to ‘commit to additional funding if nursing staff are left without at least the 6% that was announced’ – and said it was unacceptable that practices had been left without funding to deliver the extra pay more than halfway through the financial year.

The government announced in July that all salaried practice staff – including salaried GPs – should receive a 6% pay increase for 2023/24, following advice from the Doctors and Dentists Review Body (DDRB).

After negotiations between BMA GP leaders and the government, a £2.45 increase in global sum payments was announced at the start of October, taking total funding per weighted patient for 2023/24 to £104.73. However, delivery of the funding backdated to the start of the financial year has been delayed until next month.

A 2.1% pay uplift for salaried GPs and practice staff was built into the GP contract for 2023/24 – the final year of the five-year deal for general practice that started in 2019 – and the extra funding is intended to provide enough additional funding for a 6% rise, including ‘on-costs’ such as national insurance, pension contributions and other staff benefits.

However, the joint BMA and RCN statement warns that the extra funding ‘may not translate to a 6% uplift for all practice staff’ as promised by the government.

It says: ‘The way the expenses uplift is applied leads to some inequity among GP practices. It is distributed via the global sum – the payment per patient then varies following application of the Carr-Hill formula.

‘This formula allocates funding per patient for each individual practice based on age, sex, additional needs, list turnover, staff market forces and rurality. This means some practices will not receive enough additional funding to cover an entire 6% uplift for all salaried staff members, whereas others will in fact get more than they need to do so.’

GPonline warned soon after the 6% uplift was announced that delivering extra funding to pay for the increased pay rise through practices’ global sum payments would create ‘winners and losers’.

The ‘staff expenses’ element of global sum payments makes up 44% of the total – and this is the element that has been increased to cover the 6% uplift. However, the proportion of global sum income practices actually spend on staff costs can vary significantly depending on how they are staffed, including whether they have a higher proportion of partners or employees.

Meanwhile, practices in deprived areas where workload can be high but ‘weighted’ patient populations can be low because reduced life expectancy means fewer older patients – who attract increased funding – may find that their global sum income falls short of matching their costs.

In a letter to health minister Neil O’Brien, RCN director for England Patricia Marquis said: ‘Nursing staff in general practice provide vital primary care to their local communities and are the bedrock of the services available in general practice surgeries.

‘There is already clear disparity between employment terms of nursing staff working in general practice compared to other parts of the NHS. Now, their pay rise is months late, and for many the money promised could be missing.’

A DHSC spokesperson said: ‘We are hugely grateful to GP nursing staff and their teams for the work they do. Working closely with the BMA, we accepted the DDRB recommendation in full to give salaried general practice staff a 6% pay rise backdated to April. The GP contract has now been uplifted and we expect practices to pass this uplift onto salaried staff, including nurses.’