Update: Doctors and Dentist Pay Review Body [DDRB] - Process for 2024/25
Dear Colleagues,
I am writing to update all colleagues on the planned DDRB process for 2024/25 and perhaps forestall some questions or concerns about this process.
The Doctors and Dentist Pay Review Body [DDRB] was established in 1960 following the Report of a Royal Commission into Doctors and Dentists pay: colleagues should note this followed the establishment of the NHS in 1948, and the financial and economic challenges of the post-war years. A sense of the circumstances surrounding the creation of the DDRB is conveyed by the article attached at the end of this letter, which is of its time; colleagues may particularly note the first sentence of paragraph 2.
Over the years the role of the DDRB has been criticised but it is one of the few non-departmental public bodies now well into its seventh decade, so it has undoubtedly fulfilled its purpose, although probably this is in part due to the challenge of establishing an alternative.
A report by the BMA (endorsed by the British Dental Association) describing the “failings” of the Pay Review process for Doctors and Dentists is available at:
bma-report-into-the-failings-of-the-pay-review-process-for-doctors-and-dentists-2023-v2.pdf
and this gives some historical context as well as a detailed commentary on recommended Awards over the past decade.
The current situation is that the BMA has made submissions to the 2024/25 DDRB for both partners [contractors] and salaried doctors. For the past five years, no recommendations have been made by the DDRB for partners, who were considered to be locked into the five-year Agreement made in 2019/20. This is the first year following the expiry of that Agreement, and colleagues will be aware of the 1.9% uplift to the 2024/25 GP Contract imposed by NHS England. As part of this, NHS England has noted the GP Contract value may be further uplifted by this year’s DDRB Award.
The timescale for each years DDRB Report has slipped, which means its recommendations are no longer available prior to the start of the financial year in April. This year the DDRB Report is expected to be published in May/June. Once published, these recommendations have to be reviewed by the Government, and when an uplift is agreed this needs to be incorporated into practice payments by NHS England, a process that can take a few months. All this creates an in-year cash flow pressure on GP practices.
Last year (2023/24) the DDRB recommended a 6% uplift for salaried doctors, which was accepted by the Government. The 2023/24 Global Sum increase [2.1%] was fixed within the multiyear deal, creating a further cost pressure for General Practice partners, although there had been a mismatch in previous years as well.
In 2023/24 the Government independently decided to uplift the GP Contract value to create a contribution towards wage cost pressures for practices, recognising that for many practice staff, the DDRB Award is used as a benchmark for salary negotiations. Very few GP practice staff are covered by national pay scales, but salaried GPs have an entitlement to a pay award linked to the DDRB Award, if they are employed using a BMA Model Contract. The BMA Model Contract explicitly links an annual pay uplift to the DDRB Award; it is possible to employ salaried GP colleagues on other terms and conditions, providing these are “no less favourable”, but salaried GPs are very unlikely to be advised to waive this clause within their contract.
Last year NHS England provided a supplementary sum to contribute towards the costs of extending the recommended DDRB uplift of 6% to salaried GPs to all salaried colleagues employed by a practice. However, this was linked to the proportion of the GP Contract payments attributed to salaried staff, and paid via Global Sum, and for many practices did not cover the full cost of such a salary increase. GP Partners were not obliged to increase salaried staff by the DDRB Award %, unless this was referenced in their employees’ contracts, but as noted it is an often-used benchmark. This supplementary payment was made for the first time in 2023/24, and there is no guarantee this will occur again in 2024/25.
Many practices do offer staff an interim pay award from 1st April with the intention of reviewing this once the DDRB Award is known: the % Award for GP Contractors, and salaried GPs, does not have to be the same. GP partners should as for any business take into account affordability, and accountancy advice, when considering salary costs and any pay rises.
GPC England has liaised with the RCN so the latter can provide an informed background to Practice Nurse colleagues in relation to any future GP practice contractual uplifts.
I hope this background is helpful; the LMC will update colleagues once the DDRB Report is available.
Dr Julius Parker
Chief Executive
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Updated on Wednesday, 3 April 2024
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