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BMA's evidence to the DDRB on doctors' pay

Key points of the DDRB report 2017 

Each year in Autumn, the BMA submit detailed evidence on matters relating to pay, recruitment, morale and motivation for doctors' across the UK, to the Review Body on Doctor’s and Dentists’ Remuneration (DDRB). The DDRB today published its forty-fifth report for the financial year 2017-18.

The main recommendations and observations from the report are:

  • A base increase of 1 per cent to the national salary scales for salaried doctors.
  • The maximum and minimum of the salary range for salaried GPs be increased by 1 per cent.
  • For independent contractor GPs, an increase in pay, net of expenses, of 1 per cent.
  • Any future mechanism for ‘targeted’ pay solutions by health departments/employers, intended to address geographic and specialty shortages, should be backed by additional national resources and tested first.
  • DDRB noted the trend in general practice away from the contractor-partner model and towards salaried employment and locum practice. The report recognises the likely flexibility this offers some GPs, but there is a need for more hard evidence on underlying causes.

 

DDRB recommendations for 2017/18 pay review

Read the new DDRB report

Read the BMA News story

 

Comment from BMA council chair

Dr Mark Porter, BMA council chairCommenting on our evidence to the DDRB on doctors' pay, BMA council chair
Dr Mark Porter said:

“Yet again the annual pay review is nothing other than a cover for driving down real pay in the health service. The DDRB is recommending just a 1 per cent pay uplift for doctors, well below the current cost of living rise of 2.3 per cent. In real terms, doctors’ pay has sharply declined in the past five years, with junior doctors seeing their income drop by 17 per cent at a time when their morale has been badly hit by the government’s mishandling of the new contract. Over the same period consultants have seen their pay drop by 14 per cent and GPs by 13 per cent.

“Doctors will be angered by this apparent decision as it comes during a period when many are working harder than ever before in an environment of rising patient demand, stagnating budgets and staff shortages. Hospital doctors and GPs are bearing the brunt of the funding crisis facing the NHS, and are choosing to leave. This is where rota gaps, consultant vacancies and closed GP practices start. While targeted incentives of the kind proposed in this report might sound positive, they do not ultimately address the serious overall problems that are widespread throughout the country. The health service needs a proper, long term workforce plan and not piecemeal initiatives that offer only a short term fix.

“We will analyse the DDRB report in detail, but these recommendations will come as a bitter blow to a workforce already wondering whether the government knows or cares about the demoralising effect of year-on-year pay cuts.”

Each year in Autumn, the BMA submit detailed evidence and recommendations on pay for doctors' across the UK, for the Doctor and Dentist's Review Body (DDRB) pay review the following year.

 

BMA evidence for 2017/18 pay review

We submitted evidence to the DDRB for the 2017/18 pay review in September 2016.

The key arguments in our submission highlight that:

  • The British Medical Association (BMA) is submitting evidence for the whole of the UK, and is seeking a common recommendation for all doctors, though we note an increasing divergence between the four constituent UK nations. We ask that DDRB continues to assert its independence to make a full set of recommendations, irrespective of any remit that a constituent health department might seek to impose.

  • We are not proposing a specific figure for the 2017/18 pay award, but we argue that doctors should be treated in line with the wider economy, where pay settlements continue to run at higher than the public sector pay policy cap, at around 2% currently.

  • We do not support targeted recommendations to address location or specialty recruitment issues, and we do not wish DDRB to pursue its suggestion of applying funds to different approaches than pay to alleviating pressures – unless there was a substantial increase to the overall funding availability. We do however note that previous DDRB recommendations around distinction awards in Scotland, GP earnings in Wales, and clinical excellence awards in Northern Ireland, have not been implemented by the respective governments.

  • The financial distress of the NHS, and the lack of credible plans to increase capacity will further worsen recruitment and retention issues, and create real concerns around the health and wellbeing of the remaining doctors as a result of their increased yet unrecognised workload, and their lack of time and empowerment to be able to contribute to sustainable solutions.

  • We note the remit letter from England asks DDRB for observations around salaried GPs. We believe there is a significant lack of data currently available around sessional GPs (salaried and locum) on which to base any firm recommendations, for example around pay ranges, and how GPs choose to take a partnership, salaried or locums post. We request that DDRB considers who is able to provide what data with a view to a more in-depth analysis in next year’s pay round.

  • In general, we note there is a lack of data around how doctors choose their career paths, both in terms of specialty and location, but also in terms of choice between a permanent role or locum position. We hypothesise that the increased attractiveness of a locum role reflects the seeming low value and ever-increasing unrecognised workload of permanent positions. The recent moves to advertise Staff, Associate Specialist and Specialty doctor (SAS) roles at the closed Associate Specialist (AS) grade are also a reflection of this recruitment and retention issue.

 

BMA evidence

Download the BMA evidence documents from September 2016

BMA evidence (PDF)

Annex - NHS funding briefing (PDF)

Annex - SRM 2016 workforce briefing (PDF)

 

Who is the DDRB and what do they do?

Pay for doctors and dentists holding posts in the NHS on nationally agreed terms and conditions of service is considered annually by the Doctors' and Dentists' Review Body (DDRB).

The DDRB is an independent body which makes its recommendations directly to the Prime Minister and the Secretary of State for Health, and their equivalents in Scotland, Wales and Northern Ireland.

Various parties, including the Departments of Health in England and in Northern Ireland, the Welsh Government, NHS England, NHS Employers, and the BMA and BDA have sent their written evidence to the DDRB this September. The Scottish Government has not yet submitted its evidence for the 2017/18 round. Oral evidence sessions will be held with these parties between November 2016 and February 2017.

The DDRB usually reports to the Prime Minister in February or March the following year and the report is made public with the government's decision a few weeks later, for implementation on the following 1 April.

Find out more about the DDRB

Find out how doctors' pay is decided