Dear Mr Barclay
The Institute of General Practice Management (IGPM) is disappointed with the response from government in relation to the petition that was signed by tens of thousands of NHS staff and patients with regards to pay awards for staff providing NHS-funded services, but outside of the scope of the NHS Staff Council Pay Review Body.
This includes all staff from general practice – which makes up 70% of all NHS activity in England – as well as providers of other NHS-funded services such as walk-in centres, health visiting services, prison healthcare services, district nursing, community therapies and many others.
The government’s response was that:
“Independent providers remain free to develop and adapt their own terms and conditions of employment. It is for them to determine what is affordable within the financial model they operate, and how to recoup any additional costs they face. Where independent providers have adopted the same terms and conditions as offered on the Agenda for Change contract, they should review their commissioning contracts to consider whether and how to recover any additional cost pressures they now face.”
However, this is not possible. Many of these services are tied into long contracts with the NHS, with no provision for remuneration to be increased in line with inflation. The government is not providing additional funding to these contract-holders to enable them to pass on an uplift in staff pay in line with what staff on Agenda for Change are receiving. As these are NHS services, providers are also
not able to pass the burden of rising costs onto the customer. There is no ability to recoup the additional costs that they face.
As a result, many of these services are now becoming significantly impacted in their ability to maintain and deliver a high-quality level of service. Staff are leaving in droves in search of better terms and conditions and pay. Recruitment is becoming increasingly difficult. The rising costs of utilities, consumables, premises maintenance combined with increasing pension costs, also mean that providers are less able to invest in their services and are having to cut back. Instead of being able to recoup additional costs, what we are seeing is the degradation of these NHS-funded services. As a consequence, our patients are feeling the impact.
For General Practice specifically, we are seeing practice closures. At a time when activity in General Practice is consistently 20% above pre-pandemic levels and practices are having to manage patients caught in the backlog of secondary care waiting lists, we cannot afford to lose staff. Funding for General Practice staff pay rises has been capped at 2.1% for the last 4 years. Our staff deserve more, and this response from the government is lacking.
We once again are asking for a response to the Health & Social Care Select Committee report on The Future of General Practice – a response that has been long overdue, and in our view, brushed aside in favour of the Covid Recovery Plan and Fuller Stocktake.
General Practice is the most successful part of the NHS. Providing high quality care in the local community for generations of families, it is a cost-effective model that needs to be invested in – before it is lost.
