Pay Transparency Rears Its Ugly Head Again

You should already be aware that Pay Transparency has come to the fore yet again! We had all hoped that it had gone away for good but perhaps that was wishful thinking.

It was back in 2014 when the call for GPs to publish their earnings with their names first emerged. The initial proposal included the mean average in the first year and named earnings in the second year. However, these discussions eventually led to the publication of mean average earnings on practice websites, excluding certain elements like notional rent and locally commissioned services. This is still a requirement today, but we all know that the resulting figures are significantly flawed for a number of reasons.

Then during the 2019 contract negotiations, the requirement resurfaced and you may then remember that back in the autumn of 2021, the Government amended the NHS GMS and PMS Regulations, with effect from 1^st October 2021 requiring GPs earning over £150,000 of NHS Pensionable Profits (regardless of whether you were an active member of the NHS Pension Scheme or not) to self-declare their earnings information relating to 2019/20 by 12^th November 2021. This was to be an ongoing requirement.

As you know, this requirement was pulled at the last minute (well actually the day after submission was required!) even though some GPs, including some of our clients, had complied. However, it was confirmed that any data submitted would be deleted and not disclosed anywhere.

Then back in April 2023, the requirement was reinstated but in respect of 2021/22 earnings. The obligation was for GP contractors with pensionable pay of over £156,000 to declare and the revised deadline was 30^th April 2023, which is the ongoing annual deadline.

Presumably, this time around even fewer GPs complied as there is now a new window open until 1^st December to allow those who didn’t declare in April 2023 to do so. There is now the added complication that this year’s General Practice Annual Electronic Practice Self-Declaration (eDEC), has been amended to include two questions on GP Pay Transparency, questions 2N and 2O.

GPs should now have received an email from the BMA regarding this, explaining the requirements.

Question 2N asks practices to confirm that all GP contract holders have complied with their obligation to self-declare if relevant NHS earning are above the £156,000 financial threshold for the financial year 2021/22, as already mentioned above.

Question 2O refers to the requirement for practices to let eligible persons who are engaged by the partnership know about the GP pay transparency regulation, but it makes it clear that they are ‘not expected to monitor whether the individuals comply with the self-declaration once they have passed it on’.

As we know income for the 2021/22 was inflated for most practices, as it included so much Covid support income thus throwing even more GPs into the obligation. At RBP we do feel that the requirement is unacceptable. It offers no benefit to either GP nor patient and may, in fact, have a negative impact on the patient/doctor relationship. We are also concerned about the potential impact on our clients’ safety when disclosing such personal information, let alone the fallout from ‘nosy neighbours’.

This will further push more GPs to reduce their NHS work sessions or seek alternative employment thus increasing the already high shortage of GPs. Also, it should still be noted that hospital consultants have not had this obligation thrust upon them but may do so in the future. So, this appears to be a target for GPs who seem to get the worst deal of all doctors. Where was their 6% pay increase?! They weren’t eligible as they had the 2019 five-year framework contract (which hadn’t anticipated such high inflation). Do note that this is due for review next year.

Whether you comply or not is your decision, but you must be aware that any non-compliance will be a breach of your GP contract, with potential consequences ranging from receiving a 28-day breach of contract notice to the extreme of losing your contract altogether.

Back in April, the BMA acknowledged the uncertainty regarding how NHS England will verify declarations and did advise GPs to consider the impact on their personal safety.

In the BMA’s more recent email to GPs, they have given suggestions of how to answer.

Question 2O regarding the requirement to let eligible persons engaged by the partnership know, should be easy to comply with and most practices should be able to answer with ‘Yes’.

Question 2N is more problematic. Clearly if the GPs are below the relevant threshold, then you can safely answer ‘N/A’. Similarly, if all eligible GPs have correctly self-declared, then you can respond with ‘Yes’.

However, assuming the responder to the eDec is not a contract holder (normally it would be an employed practice manager), then it has been suggested that this question be left blank, as it is quite likely that the practice manager would not know, as they may not be party to such personal information and the contractor holders may not have advised them as to whether they are eligible or not. However, it is anticipated that, as the eDec is completed on-line, this will not enable the responder to continue with the completion of the form. In these circumstances GPC England recommends this question is left blank, but if the eDec cannot be submitted because this question is unanswered, the practice is recommended to send the following email to ssd.nationalservicedesk@nhs.net :

Dear Colleague

I am unable to complete Question 2N because I do not have the information available to be assured of the accuracy of my response.

[Practice Responder Name]

It is not recommended that anyone answers ‘No’ as that clearly indicates a breach of contract.

It remains to be seen as to where this will lead us but suffice to say that we, at RBP consider these requirements to be wholly unacceptable. You, the GP and/or contract holder will need to decide what action to take.