LMC advice letters
Written: 17 July 2023
I am writing to update all GP colleagues following the publication of the 51st Doctors and Dentists Pay Review Body (DDRB) Report. This is available at: Review Body on Doctors’ and Dentists’ Remuneration – 51st Report 2025 (publishing.service.gov.uk)
The Government has announced that it has accepted the DDRB Report recommendations, meaning an increase of 6% for doctors within scope of the Report. This includes salaried General Practitioners; GP Contractors are currently in the fifth and last year of a multiyear agreement, and therefore no recommendation has been made by the DDRB in relation to GP partners.
This means that the 2023/24 2.59% uplift to Global Sum, raising this to £102.28 per weighted patient, is unchanged, this uplift included a nominal 2.1% for expenses.
The BMA salaried scale for salaried GPs will rise by 6%; however, colleagues should note that the sessional GP Committee has stated that they are recommending the GP salaried scale should rise by a recommended £9K uplift, raising the salaried range of £78514 – £113663. However, the BMA’s official current recommended salaried doctors scale following the DDRB uplift is £68 974 – £104 086 [figures awaiting final confirmation but including the 6% uplift].
In relation to salaried GPs employed by practices, the BMA and LMC provide the following guidance:
- Pay arrangements with Salaried GPs are based on their individual contracts with their practices, the DDRB Award does not automatically apply to Salaried GPs in employment, but it is applied to the Salaried GP pay scale published by the BMA.
- Since 2004, and 2015 in terms of standard PMS Contract Agreements following the PMS Review, the GMS Contract requires GP practices to employ Salaried GPs on “terms no less favourable “than the Model Contract [which is the BMA Model Contract for Salaried GPs].
- This does not mean Salaried GPs must be employed on terms which exactly replicate the Model Contract since by mutual negotiation and acceptance of different terms Salaried GPs may have their contract terms modified to reflect different responsibilities or patterns of working within a practice, which may be more advantageous to both parties.
- The Standard Model Contract includes the phrase “annual increments on [incremental date] each year and in accordance with the Governments decision on the pay of General Practitioners following the recommendation of the Doctors’ and Dentists’ Review Body”. If this clause is within the contract of employment, then the full DDRB uplift should be made. If it is not, and a different calculation/review is provided for, the latter should be applied, or if the contract is silent on this point [annual pay increases] then the BMA encourages GP employers to pass on the full DDRB uplift, but they are not required to do so under the salaried GPs employment contract.
There is no national salary scale for the majority of clinical and non-clinical staff employed in GP practices: the LMC is aware that the DDRB recommendation is often seen as a benchmark for practice staff, although GP partners can set salaries within their practice according to their own arrangements and any terms and conditions included in their employee’s contract.
In previous years there has been no in-year supplementary uplift to GP contract payments to bridge the gap between the nominal expenses % uplift within the Global Sum, and the DDRB recommendation. This year, the Government has stated:
- The GP Contract will be uplifted to provide funding for salaried General Practice staff. This funding will be backdated to April 2023, and it is our expectation this funding is passed on promptly to all salaried General Practice staff. As self-employed contractors to the NHS, it is for GP partners to determine uplifts in pay to their employees.
The LMC is awaiting further information in terms of how a supplementary uplift will be applied in year; this is complicated by the fact that payments under the contract are capitated, but obviously GP practices will vary in terms of salaried GP staffing arrangements. In addition, there is no confirmation that a supplementary uplift will cover other GP practice staff aside from salaried GP colleagues. The DDRB recommendation applies contractually to salaried GPs if the BMA Model Contract is used, or an equivalent contract includes reference to the DDRB Award in terms of an annual uplift. As soon as further information is available on these points, I will circulate this.
In previous years the DDRB has made recommendations in relation to the GP Trainers grant and appraiser fee. The DDRB Report indicates that the appraiser fee (currently £584) will no longer remain within the DDRB remit and has made no 2023/24 recommendation in relation to the Trainers grant, which is therefore unchanged.
In relation to other medical colleagues, Consultant salaries will rise by 6%, but there is no recommendation (and therefore there will be no uplift) in relation to the Consultant Reward Schemes. SAS Doctors will receive 6% and Doctors in Training (Junior Doctors) will receive 6% plus a consolidated £1250 increase for all pay points.
All DDRB recommended pay rises will be backdated to April 2023.
NHS Nurses have already been awarded a 5% pay increase together with a non-consolidated (non pensionable and not added to future years pay scales) one-off uplift dependent on their pay band. I would recommend colleagues await further details about any supplementary in-year funding increase for practices linked to the DDRB pay award before considering any award to practice staff equivalent to those employed under Agenda for Change (AfC) contracts in other environments; AfC does not apply to General Practice staff.
ARRS staff are reimbursed under Agenda for Change rules in terms of the reimbursable allocation for their roles which PCNs can claim. I am aware of considerable concern amongst PCN colleagues that the arrangements for ARRS staff have not yet been fully confirmed beyond March 2024, nor have plans for the PCN DES after that date. NHS England has stated that “staff employed through the Scheme will be considered part of the core General Practice cost base beyond 2023/24“; however, this does not describe how the allocation of such staffing costs will be managed. It seems highly likely that the PCN DES will be available to practices beyond March 2024, although less likely that there will be the significant increases in PCN ARRS allocations that have occurred over the past five years.
I hope this update is helpful; the LMC will circulate a further update once more details are available.
Dr Julius Parker, Chief Executive
I am writing to update colleagues following my letter of 17th July 2023 regarding this year’s DDRB Award.
Unfortunately, my update is essentially to say that neither NHS England nor the Government has provided any further information in terms of the proposed 6% uplift to the GP Contract; colleagues should note that, in recent years, no supplementary uplift to the Contract has been made available. This year, the Government announced, following the 6% DDRB Award, that the Contract would be uplifted to cover all salaried General Practice staff; this would be an unprecedented extension of financial support, but without further details, it is not yet known how this will be implemented. The LMC is aware many practice colleagues are aware of this development, and the RCN has written to all Practice Nurses, asking them to request a 6% salary uplift, in the light of the announced 6% Contract uplift. This is even though the College must be aware no such contractual uplift has been received, or in fact offered, because the uplift was to cover an increase in staff salaries of 6%, which does not imply a full contract uplift of 6%.
In fact, at present, it is unclear how a capitation-based contract can be uplifted to reflect expenses that will be individual to each practice, even though list size will be an approximate proxy for employed staff numbers. It is also unknown if any supplement to cover a salary uplift will also cover increased employer on-costs, be recurrent in terms an uplift, or reflect the 2.1% element of the 2023/24 Global Sum uplift for expenses that has already been received.
The only contractual uplift practices are currently expected to apply is to salaried GPs on the BMA Model Contract, and to any other contracts that also specifically reference an annual uplift linked to the DDRB Award, which the BMA Model Contract does.
The LMC is aware that some practices will have already provided staff with what may have been intended to be an interim pay uplift from April 2023, in anticipation of the DDRB Award,which some practices use as a benchmark. At present, unfortunately, the LMC does not have further advice to colleagues on this issue; once it is available, I will circulate to all practices.
Dr Julius Parker, Chief Executive