SFE Global Sum and Locum Reimbursements Arrangements 

We are writing to all colleagues following the publication of the 52nd Doctors and Dentists Pay Review Body (DDRB) Report and the Government’s subsequent response to this.

The Government has announced it has accepted the recommendations of the Report. For the first year since the 2019/20 – 2023/24 multi-year deal, the DDRB has made recommendations in relation to both GP contractors and salaried colleagues.

The way in which the DDRB Award of 6% for Contractors will be implemented has now been finalised between GPC England and NHS England/DHSC. The 2023/24 Global Sum was £104.73. The aggregate rise in the 2024/25 Global Sum (combining the interim April 2024 uplift with the DDRB Award) will be 7.4%, an increase of £7.77 giving a new Global Sum of £112.50.

The OOHs deduction remains at 4.75% and in absolute terms this will change from £4.97 to £5.34, aligning with the total uplift of 7.4%.

The value of each QOF point increase relates to the Contractor Population Index; the average practice list size rose to 9964 on 01/01/24 and the QOF point value in 2024/25 will therefore be £220.62, compared with £213.43 last year (an increase of 3.4%).

The BMA salaried scale for salaried GPs will rise by 6%, giving a salaried scale of £77501 to £116950 (these figures await final confirmation).

In relation to salaried GPs employed by practices, the SSLMCs provide the following advice to partners:

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 and thus GPs, on an agreed pay scale will see this rise accordingly.

Since 2004, and 2015 in terms of standard PMS Contract Agreements following the PMS Review, both the GMS and PMS Contracts require 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.

Colleagues will be aware that the DHSC, in announcing this year’s award, stated that:
The uplift to the Global Sum is calculated to cover all practice staff – not just GP partners and salaried GPs. This includes practice nurses, reception, management and other practice staff. We firmly expect GP partners to honour the intent of this uplift and award the full 6% pay rises to all their staff.

There is no provision within the DDRB remit to recommend GP practice staff pay arrangements outside salaried GPs who have a BMA Model Contract which references a DDRB linked annual uplift. GPC England has made it clear to NHS England that whether or not they “firmly expect” GP partners to uplift salaried staff by a certain percentage, practice staff pay is a matter for employers, as Independent Contractors, and the LMC advises partners to follow existing contractual terms and conditions, where these reference pay and uplift arrangements.

There is no national salary scale for the majority of clinical and non-clinical staff employed within GP practices, however, the LMC recognises that many GP practice staff do use the DDRB Award as a benchmark; and national organisations, such as the RCN, on behalf of GP Practice Nurses, are likely to take the same view. Partners will also want to reward staff for their commitment and dedication during what has been a challenging time for General Practice, and clearly partners are facing difficult pressures in terms of expenses inflation, the need to recruit and retain staff in a competitive economic environment, and staff expectations.

If partners have provided staff with an interim salary uplift based on the April 2024 Contract uplift, this should be accounted for within any further uplift since the £7.77 (7.4%) uplift is inclusive of the April Global Sum uplift.

GP colleagues should note that the Global Sum uplift is a capitation-based payment, dependent on the size of a practices weighted registered list. It is unrelated to the 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 staff expenses 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.

Practices will be able to calculate their anticipated further uplift which NHS England, recognising the delays last year and the cash-flow issues faced by many practices, are committed to delivering within the September 2024 practice pay run. This payment will be backdated to April 2024. A 7.4% uplift is above current inflation and does reflect the Secretary of State’s public commitment to supporting General Practice. The LMC hopes this award will provide GP partners with a financial breathing space, and perhaps an opportunity to stabilize what has self-evidently become an increasingly untenable financial environment. It does not meet GPC England’s aim of an uplift restoring GP Contract income to 2019/20 levels, which it is estimated would have required a 10.7% uplift, a reasonable objective given other recent Branch of Practice pay settlements.

The DDRB removed the appraiser fee from its remit in 2023/24; confirmation of the Trainers Grant arrangements are awaited.

The LMC is awaiting announcement of the Dispensing Fees adjustment and will circulate this when available; this is currently scheduled for October 2024.
The AfC [Agenda for Change] pay scales have been uplifted by 5.5%; the ARRS allocation was uplifted by 2% from April and will not be uplifted further, thus for ARRS staff reimbursed under AfC salary scales, this will be a cost pressure for the overall PCN ARRS allocation budget.

In relation to other medical colleagues all Consultants and SAS doctors are being awarded 6% in addition to already agreed settlements. Junior (to be called Resident after September and colleagues may already see this phrase used) Doctors are receiving a 2024/25 Award within the context of a two year pay offer which is to be put to a vote of members and may end their current Industrial Action.

Dr Julius Parker, Chief Executive