Apr 28

GP Pay Transparency FAQs

From 1 October 2022, the GMS and PMS regulations were amended to require some GPs to self-declare their earnings. This was originally proposed in 2019 but delayed on 2 occasions in Autumn 2021 and Spring 2022. Despite persistent concerns from the GP committee of the BMA, NHSEI have announced that as part of the imposed contract for 2023/24, the data collection will now begin in April 2023 with 2021/22 NHS earnings.

The LMC share the view of the GPC that this action singles GPs out; there are no similar proposals for other clinicians in the NHS, or anywhere else in the UK. This action provides no benefit to GPs or patients and will increase acts of aggression and abuse towards GPs and practices. It will be damaging to morale and wholly reduce the ability to recruit and retain GPs. Some of you heard from the Acting chair of GPCE, Dr Kieran Sharrock, who shared his concerns at our recent LMC committee meetings. We had hoped that a delay in issuing the contract variation documents by NHSEI to practices would provide a reason for GPs to ignore this declaration, but this no longer appears to be the case.

What do I need to do?

All of our local GPs now face a choice if their earnings for 21/22 are above the threshold – to declare their earnings despite the above concerns, or to intentionally not declare their earnings which is a breach of their contract.

How do I declare?

The BMA GPC guidance can be found here, and summarises the views and concerns of GPC England. The declaration requirement applies to all GPs and their total NHS earnings. It applies equally to partners, salaried GPs, and locums, and if their total income from all their NHS work is over £156,000 for the year 21/22, they are meant to declare this.

For partners, the requirement is now in your GMS, PMS or APMS standard contract as a clause.

For salaried GPs, your employer is meant to ask if they can amend your employment contract to include the need to declare your earnings – you do not have to agree. Practices will be required to “use reasonable endeavours” to amend their existing employment contracts with salaried GPs to include the same obligation to self-declare earnings as set out in the regulations. Practices can only amend existing employment contracts with the salaried GP’s agreement. We suggest you document a conversation between the practice and any salaried GPs covering the above, and this will fulfil your obligation. It is unlikely the BMA salaried model contract will be amended to include this.

For locums, you are meant to complete the template provided by NHSEI and self-declare.

What work counts as “NHS income”?

  • Work done by any individual who holds a GP contract – including partners who are not GPs
  • Work done via a sub-contracting arrangement, including as an individual medical practitioner, a partnership or a limited company
  • Anyone working for the NHS under:
    • i. a contract of employment
    • ii. a contract for services
    • iii. or as a company officer
  • Anyone working as an individuals engaged by a third party to provide clinical services (for example a locum engaged via an employment agency).

What will happen if I do declare?

Your declaration will be published by NHS Digital in a national publication, listing:

  • Name
  • Job title
  • Earnings (in bands of £5,000)
  • The name of the organisation from which the greatest earnings were from
  • The number of other organisations that they earn from.

Through the act of self-declaration, you are consenting to publication. Individuals should therefore carefully consider the implications before self-declaration and how you would be supported in the event of personal queries or abuse arising from this.

What will happen if I don’t declare, or don’t realise I need to?

We have received several enquiries from constituents asking what will happen if they do not complete the declaration. An eligible GPs earning declaration will be checked against the HMRC returns for that year; only once this has happened will it be apparent if a GP has not declared and should have. NHSEI would then need to clarify that the earnings are from NHS sources, and then raise this with the practice or individual.

What does a breach notice mean?

For GP partners, the breach is to the practice contract. It is unclear where the breach occurs for a salaried or locum GP and how this could be enforced. In situations where there has been a breach of contract, but the breach is capable of remedy (i.e., completing the pay declaration), a remedial notice may be issued. In doing this, the commissioner must provide details of the breach and the steps that will need to be taken to remedy it. Unless the breach places patients at risk or is a financial risk to NHS England, at least 28 days will be allowed to remedy the breach. This means that partners must declare earnings in the way prescribed within the time limit to avoid being in breach. If the contractor fails to remedy the breach, the commissioner may send notice of termination of the contract.

So I could wait, and then declare if and when I get a breach notice?

Yes – given this contractual clause does not place patients at risk, and is not a financial risk to NHSEI, you would have at least 28 days to then complete the declaration.

The LMC have told our local NHSEI and ICB colleagues that we do not support pay transparency declaration, and that we will strongly support any GP regardless of whether they choose to participate or not. However, the ultimate decision sits with every individual GP. We will continue to lobby against this via GPC and LMC conference and want to hear from any GP or practice who receives correspondence from NHSEI or the ICB relating to this declaration.

Leave a reply

Your email address will not be published. Required fields are marked *