DDRB Pay Uplift- 6% 2024/25 ( 2%+4% funding

As recently announced the Government has accepted the Doctors and Dentists Pay  Review Body (DDRB) recommendation 24/25 of a 6% uplift. This is inclusive of the  2% uplifts for contractor and other staffs pay expenses which was funded in the  Global Sum in April; the DDRB award adds another 4% on top of this. The 4%  additional uplift is backdated to 1 April 2024. 

Practices should receive funding for the 4% uplift plus back pay element this month. 

In very general terms the recent DDRB award funding uplifts have resulted in a 1p  rise per patient per day – this is still woefully insufficient to stabilise practices which  are collapsing.  

But owing to the way in which the funding is allocated not every practices will receive  sufficient funding to cover the 6% uplift for very member of staff. The additional 4 %  is distributed on the basis of patient list size which does not match in every case  practice’s increases in staffing costs in applying the uplift. Practices which have more  GPs, pay higher salaries, or have fewer patients per staff members than others, are  at risk of not receiving the additional funding needed via the Global Sum per  weighted patient receive to ‘cover’ the award.  

Conversely, practices which have a different balance of weighted patient list GPs  and salary costs may find they have an increasing in funding to go beyond the 6%  for Partners.  

See the attached Focus on the 6% DRBB pay award application of Global Sum  briefing paper for examples of how some practices could fare . 

Once again the DDRB did not include in its award an element to cover the increase  in non-staffing expenses and the Global Sum element for this will not be uplifted  beyond that added for inflation in April . 

The DDRB is not charged with recommending Pay uplifts for non – GP staff yet in a  repeat of last year the Government has announced that it expects that Practices will  uplift all GP and non-GP staffs pay by 6%. Practices, as the employers of staff, have the authority to decide on the basis of affordability the level of uplift for non-GP staff.  

Yet in many practices which do not have the costs totally covered by the uplift in  Global Sum will apply the uplift because they need to keep their staff and the staff  themselves believe that the award is meant to apply to them. 

It is important to bear in mind that increases in the National Living Wage in April of  9.8 % and already paid subsume the 6% DDRB.

The attached Focus On document provides further detail on the funding and  application of the uplift. The anomalous basis of the funding of pay uplifts remains  creating a situation in which the Government claims the uplifts are fully funded, but  the distribution of that funding is such that the costs are not fully covered in every  case 

20240920-focus-on-how-the-2024-25-ddrb-pay-award-is-added-to-national-funding-and-distributed

The BMA has invited Practices to contribute to its survey of Practice Funding and  you might wish to participate by taking a simple series of Q&As – you can find the  survey here: https://www.research.net/r/H9CYXCP 

Sub-dermal contraceptive implants (Nexplanon) 

From 1 January 2025, GP practices will be able to order sub dermal contraceptive  implants (Nexplanon) directly from the supplier and claim back the cost.  

The Statement of Financial Entitlements (SFE) will be published on 1 October 2024  including this change. This will mean that patients do not have to go to the pharmacy  to pick up the implant themselves and then make a further GP appointment to get it  fitted. 

General Practice key stats August 2024 

Data just in from the BMA show the performance of General Practice in a context of  adverse GP workforce conditions. It’s too early to say that Collective Action (limiting  GP contacts to 25 per GP per day) has dinted the overall number of appointments  per working day in August. You might want to share this information with your PPG. 

GP Appointments – August 2024 

  • Over 27.6 million standard (non-Covid-19 vaccination) appointments were  booked in August 2024. An average of 1.32 million appointments were  delivered per working day during August, a slight decrease from the previous  month (1.36 million appointments). 

o This is the lowest average number of standard appointments delivered  per working day since August 2023 (1.28 million appointments per  working day), but also more than in August 2022 (1.21 million). 

  • From September 2023 to August 2024, approximately 363 million  standard appointments were booked. 
  • In terms of access, 45% of appointments in August 2024 were booked to take  place on the same day, a slight increase from the previous month (44%). Nearly 83% of appointments were booked to take place within 2 weeks in  August 2024, the same as the previous month. 
  • Around 65% of appointments were booked to take place face to face, the  same as the previous month. 
  • Around 44% of appointments were delivered by a GP in July 2024, the same  as the previous month. 

GP Workforce – August 2024 

The NHS had the equivalent of 27,807 fully qualified full-time GPs in July 2024 – an  increase of 145 FTE GPs since the previous month. We have the equivalent of 1,557  fewer fully qualified full-time GPs than we did in September 2015. During this time,  there has been a rise in the number of patients, with August 2024 seeing yet another  record-breaking number. GPs are now responsible for about 18% more patients than  in 2015, demonstrating ever mounting workload pressures

  • In August 2024, the NHS had the equivalent of 27,807 fully qualified full-time  GPs – an increase of 145 FTE GPs since the previous month. 
  • Over the last 12 months, there has been an increase of 561 fully  qualified FTE GPs. 
  • Between September 2015 and June 2023, the NHS had been losing FTE fully  qualified GPs at an alarming rate. While recent gains are positive, they have  not been sufficient to make up for historical losses. We still have the  equivalent of 1,557 fewer fully qualified full time GPs than we did in  September 2015. 
  • The GP Partner workforce in particular has been shrinking rapidly since 2015.  There were 16,386 FTE GP partners in August 2023 but 15,925 in August  2024: a total loss of 461 FTE GP partners in the past 12 months alone. 
  • Including GP registrars there were a total of 38,461 FTE doctors working in  general practice in August 2024, an increase of 1,498 FTE from July 2024.  This increase includes an additional 1,353 FTE GP registrars from the  previous month. 
  • The number of GP practices in England has decreased by 89 over the past  year – reflecting a long-term trend of closures and mergers. 
  • This fall in both GP numbers and practices coincides with a rise in patients: as  of August 2024, there was another record-high of 63.47 million patients  registered with practices in England – an average of 10,139 patients  registered per practice. 
  • As a result, each full-time equivalent GP is now responsible for an average of  2,282 patients. This is an increase of 345 patients per GP, or about 18%,  since 2015.  

Please note that the fully qualified full-time equivalent GP statistic is the sum of  partners, salaried, retainers, and locums only – GP trainees are not included

Is the NHS Broken? 

A snippet from the blog of Roy Lilley, ex NHS Trust Chairman and now health policy  analyst, which succinctly counters the repeated refrain from the new SoS for Health  (https://www.bbc.co.uk/news/articles/cx2k0449747o ) is worth a glance: 

A broken NHS? 

  • The NHS sees 1.7m people every day, the equivalent of the populations of  Birmingham and Leeds, more than at any time in its history. 

Does that sound broken, to you? 

  • It deals with more 999 and 111 calls than it has done since 1948. As of early  2024, ambulance services handled approximately 828,345 calls in January  alone… a 22% increase compared to the same period in the previous year. Does that sound broken, to you? 
  • Provides care to a bigger population, of older, more vulnerable people. Poor  people and socially disadvantaged people… with two thirds of the beds the  NHS had 25 yrs ago. 

Does that sound broken, to you? 

  • GPs see 365m people a year, that’s the equivalent to one in ten of us every  week. 70% face-to-face, most of the rest on the phone or facetime. Nearly  half, on the same day. 

Does that sound broken, to you? 

  • The very smart NHS App has more subscribers than Netflix. 

Does that sound broken, to you?

  • NHSE has subsumed Unimprovement, NHSX, NHSDigital and HEE into its  organisation. The biggest reorganisation Whitehall has ever seen and reduced  staff by nearly one third. 

Does that sound broken, to you? 

  • It has trialled and established 12,000 virtual wards to help fix discharge and  admissions demand. 
  • Coped with rejigging 1.2m appointments lost through strikes… over which it  has no control. 

Does that sound broken, to you? 

  • Since early 2024, the trajectory of patients on the waiting list is starting to  move down. In January 2024, the waiting list fell to 7.58 million from 7.6  million. A decrease of about 192,659 patients. The numbers could be better if  it wasn’t for the strikes. 

Does that sound broken, to you? 

The service has coped with cuts to its budgets, idiot, useless politicians that don’t  have the wit-nor-guts to sort out social care. 

Damage to its workforce through Covid and Brexit… and along the way, established  160 new diagnostic centres and watched powerless, as bits of hospitals have fallen  down, through the lack of capital investment. 

The NHS is not broken. It’s battered and struggling with; 

  • a lack of supply-side capacity, 
  • a dearth of investment in capital projects 
  • the collapse of social care. 

Source R Lilley Blog NHS managers Sept 2024 

Chairman: Dr David Humphreys Honorary Secretary: Mr Joe Chattin Treasurer: Dr Liam Hosie 

If you should have a query or require more information on any of the above, please contact the LMC Office on wiganlmc@nhs.net

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