DDRB Report and Uplifts 2013
The 2013 report of the Doctors’ and Dentists’ Review Body (DDRB) was published on Thursday 14 March and recommended an uplift of 1% for all doctors.  Regrettably, the government in England has not accepted the DDRB’s recommendations in full for GP contractors and has decided to reduce the uplift recommended for this group. The Review Body recommended a 2.29% uplift to the overall value of GMS contract payments, intended to deliver a 1% net uplift for GPs after allowing for staff costs and non staff expenses. This recommendation was based on a formula carefully constructed to recognise rising costs in general practice.  The government in England has however imposed a reduction in the uplift recommended by the DDRB.  The GP contract will receive a 1.32% gross uplift, which the government says is designed to deliver a 1% net increase to GP income by restricting increases in practice staff pay, also to 1%.  It has not yet confirmed whether this uplift will be applied differentially across the various funding streams.  If this is the case, some GPs will receive a lower uplift than others. We are bitterly disappointed but not surprised that the government has decided to interfere in the uplift deemed to be fair by the review body. We believe that in view of rising expenses, this level of gross uplift is likely to deliver little, if any, net increase in income, even if the structure of the contract were to remain unchanged. The impact of this 1.32% gross uplift must be seen in the context of the imposition of far reaching contract changes from April 2013; we expect the detrimental impact of this year’s imposed contract changes on the income of most GP contractors to offset any uplift to contract prices. GPs will not forget this in a hurry and will bear it in mind when asked to put themselves out for the CCG. To expect GPs to happily participate in an agenda that involves cutting NHS resources, privatising the NHS, and then GPs getting the blame when it fails, shows that someone somewhere isn’t thinking very clearly.  GPs may have to help them see through the fog of their own making. We will provide a further update once we know how the 1.32% uplift to GMS contract prices will be delivered. The following uplifts have been recommended and accepted:

• Salaried GPs – the Review Body has recommended that the minimum and maximum of the salary range be increased by 1% for 2013/14.  As a result of the DDRB’s recommendation, salaried GPs on the model salaried GP contract should receive an uplift of at least 1% to their salaries.

• Trainee GPs – the Review Body has recommended an increase of 1% to GP trainees’ basic pay.  For 2013/14 the supplement for trainees will remain at the current rate of 45%. 

• GP Trainers – the Review Body has recommended a 1% uplift to the GP trainers’ grant for 2013/14.  This is in addition to the £750 per annum continuing professional development supplement. 

• GP educators – the Review Body has recommended a 1% uplift to their pay scale for 2013/14.

Contraceptive Implants Enhanced Service
The Department of Health (DH) has confirmed that as from 1 April 2013, the IUCD NES will come within the remit of Public Health England, and will, therefore, be for local agreement. Locally, all sexual health services – including IUCD – are provided through Assura with practice subcontracting arrangements. The DH are planning a wider review of contraceptive services, which would be likely to be led by Public Heath England, and we will update you if there are any changes that may impact on the Tees delivery model e.g. the development of a DES. As it stands at the moment, practices will see no changes.

Focus on Excessive Prescribing Guidance Update
The GPC has published this updated version of its Focus on excessive prescribing guidance (to follow), which includes a new section on shorter duration prescribing, highlighting that shorter duration prescribing can be associated with increased costs and decreased compliance.

Locum Employers Pension Contributions
Practices and individual locum GPs are understandably concerned about the proposed changes to locum employer’s pension contributions, which are currently paid by PCTs and are asking many questions on how the contribution payment will be managed when, it is proposed,  practices become responsible for the payments on April 1^st. Although not confirmed, it is understood, from the Pensions Agency, that it is very likely that this change will be implemented from 1^st April and that the process for making the payments will be as below.

• Locums themselves will physically make the payment to the Local Area Team. They will pay their employee’s contribution and the employer’s contribution at the same time.

• ‘GP Locum Form A’, which validates that a locum has worked for a practice, will still be used. The form will include a statement to say that the locum wishes to pension the income and will also detail the amount of employer’s contribution to be paid.

• The same deadlines for payment will still apply – the locum will still be required to send the cheque and form by the 7th day of the month following the month in which the income was earned.

• ‘GP Locum Form B’ (a record of all locum work undertaken in that month) will also be retained.

For GMS practices, the additional costs will be reimbursed via global sum. Practices should, therefore, expect to pay the 14% employer’s pension contribution on top of any locum fees. The GPC are seeking urgent clarification from the Department of Health as to how the costs will be reimbursed for PMS practices. Once we have received confirmation of the process for making the payments, we will be sending out a template pro forma invoice for locums to use to set out their fees in detail, including the 14% employer’s pension contribution. 

The Information Governance Toolkit
Version 10 of the Information Governance Toolkit for General Practice went live in June 2012 and the deadline for final submission is 31 March 2013. The toolkit encompasses 13 requirements for general practice to self assess against. Connecting for Health (CfH) state that completion of the toolkit is necessary in order for practices to ensure that their CfH (or, from 1 April 2013, the Health and Social Care Information Centre) services continue to be provided. One person from a practice will have been nominated as the IT lead and they will register for a user account and complete the online self-assessments on behalf of the practice. We recommend that practices submit their 2012/13 self assessments by the deadline. This guidance on information governance for GPs clarifies what is and is not mandatory. PCTs have traditionally provided support to practices in regards to their information governance arrangements. If practices require assistance with completion of the online toolkit the national information governance team can also be contacted via the ‘help’ section of the toolkit.