Sefton LMC Hot Topics Bulletin 27 th September 2024

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 practice 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 increase 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.

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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.

PCN DES 24/25 _ARRS and funding of newly qualified GPs

The revised PCN DES Specification which sets out the funding and additionality criteria for the recruitment of newly qualified GPs has just been published. Attached is a copy of the specification which can also be accessed on the LMC website. Section 7 .2.6 and 7.3 are the relevant parts.

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MCCD changes 9^th September

The formal introduction of the Medical Examiner system for the confirmation of cause of death has produced several key changes to the MCCD process. A useful before and after comparison of these compiled by the RCOP is attached.

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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).

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 145FTE 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 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.

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.