NHS England has announced proposals to ditch the independent annual review of GP expenses. However, GP leaders have warned that practices could lose out as a result of the decision.
Ditching the review would mean the Review body on Doctors’ and Dentists’ Renumeration (DDRB) would no longer review practice expenses, leaving the NHS and the GPC to negotiate the total funding uplift for practices between themselves.
The NHS England document said: ‘Our view is that it seems anomalous that DDRB is a pay review body, yet it makes recommendations for independent contractors which involves considering the level of their expenses. In many ways this is not a logical position. Independent contractors, by their very nature, are able to influence the level of income and expenditure which their businesses experience.
‘[A]dditional income could also be gained from NHS and other public sector work. [E]xpenses could be reduced through seeking greater efficiencies, for example, through… the introduction of federated approaches and sharing of back office, functions and staff across practices; appropriate increased delegation to other members of the practice team; and partnership working with local pharmacies.’
It added: ‘If the BMA, and DDRB, feel it is no longer appropriate to use a formula to calculate the gross contract uplift, we would suggest a better alternative would be for NHS England and the negotiating parties to discuss and consider an appropriate uplift for expenses within future contract negotiations.’
This news arrives in lieu of a thorough re-examination of GP budgets, productivity and workloads alongside the predicted deficit the NHS will face by 2021 as well as a damning report regarding Government involvement in the managing of the NHS.