I’m sure everyone has had some sleepless nights recently wondering how to make a square peg (funding) fit a round hole (pay uplifts).

When it comes to finances, we’ve had a bit of a shambolic time of late – for example, the announcement about the 6% uplift, which isn’t an additional 6%; trying to find out when that money was going to be in our accounts; and the Chancellor’s Autumn Statement announcing a 9.8% increase in the National Living Wage (NLW).

Of course, the NLW announcement was very welcome. We all want to pay our non-clinical teams the remuneration that their roles deserve. However, how do we fund this?

The 6% uplift in many practices is nowhere near enough to fund the uplift and cover oncosts, so already there’s a hurdle in the way. Factor in budgeting salaries for the next financial year and the NLW increase to £11.44 per hour, and the house of cards starts to become pretty wobbly.

Mike Neville (IGPM National Lead – North) wrote a fantastic statement at the end of last month on behalf of members about the wonky uplift and the massive concerns from 1^st April onwards.

Only last week, I met a local MP to discuss the impact of these decisions. To say he was horrified was an understatement! Once the foundation had been set – i.e., that only 7.2% of total NHS funding is being allocated to primary care (a decrease of 0.8%) – I then outlined the bullet points below.

I’m sharing these with you in the hope that you too will contact your local MP. This is your ‘call to arms’ – the louder our collaborative voices, the more hope we have of being heard.

In the words of Citizen Smith (c.1977), ‘Power to the people!’

Key points to share with MPs

• A 6% uplift was announced via the media in July 2023, backdated to 1^st April 2023.
• As normal, an uplift was applied to the Global Sum payment from 1^st April 2023. This year, 2.1% was awarded.
• Very little information was given to practices about this. The information shared was from the media.
• The information released indicated that the uplift had been calculated on the basis that 44% of our Global Sum payment represented staff costs. In reality, it’s 60% – 90%.
• It became apparent that the 6% was not in addition to the 2.1% already received. The uplift would be 3.9%, which when added to the 2.1% already given, equals 6%.
• Payment is based on weighted list size not actual list size.
• The uplift announced equals £2.45 per weighted patient. However, 5% of this is top-sliced for OOH provision meaning that practices receive approximately £2.33 per weighted patient.
• It’s supposed to cover the uplift including oncosts (NI, tax, pension contributions). For forecasting purposes, we calculate this nationally at 29%.
• The Chancellor’s Autumn Statement informed us that the NLW is being increased by 9.8% to £11.44 per hour from 1^st April 2024. This is welcome news for our employees.
• It needs to be properly funded in the Global Sum payment.
• In our public sector role, we have no consumers to pass increased costs on to.
• Practices are now losing sleep over their financial viability, and many are already in difficulty.
• It’s very possible that there will be redundancies among other practices, which will affect patient services and care.
• Partners (including managing partners) are already faced with reducing their drawings to fund the 6% uplift.
• Partners will not take another reduction and therefore they will leave general practice.

Will you make the time to contact your local MP? The financial viability of our general practices may depend on it.