In February 2026 the sessional GPs committee held a pay strategy day, with funding for this meeting supplied by GPDF in recognition of the ongoing work of the sessional GPs committee as advocates for matters relevant to salaried, locum and portfolio GPs. Given the current pressures on existing funding, the arrival of new funding streams and the expectation of a new GMS contract in England, to be negotiated before the end of the current parliament, having clear policy would be a necessity in any forthcoming discussions with government.
The motion passed
This committee believes:
(i) GPs and consultants have equal status in the NHS
(ii) career earnings for professional duties should be the same for consultants and GPs,
regardless of a GP's contractual status
(iii) appropriate GP funding should not rely on use of a historic partnership model with
unlimited liabilities in order to obviate employers NI contributions
(iv) the current consultant pay scale would be the most straightforward to implement for
salaried GPs to ensure career earnings for professional duties are equivalent and
(v) general practice funding mechanisms must be developed to enable an appropriate
pay scale for salaried GPs to operate
Background to the motion
Since the arrival of the new GMS contract in 2004 it became possible for practices to employ GPs as salaried staff. Prior to this, aside from being a self-employed locum on a time-limited contract, there was a requirement to be a partner to work in general practice. However, such partnership, under the 1890 Partnership Act, leaves partners with unlimited liabilities and if any contract with an NHS commissioning body is unable to be fulfilled there is a risk that the contract will be terminated, with the partners facing the costs of winding up their business. This could involve substantial redundancy payments as just one of those costs.
For many GPs this is a risk too great, which is why the ability to work as a salaried GP from 2004 onwards was so attractive. However, this has caused its own problems. There was never any agreed pay scale, merely a recommended pay range, which is adjusted regularly by government after taking into account the report written by the DDRB (Review Body on Doctors’ and Dentists’ Remuneration).
This pay range has a lower end falling well behind current salaried GP pay.
The BMA has in recent years created its own recommended pay range which is more realistic than the range suggested by the DDRB. For example, for England in 2025/2026 the DDRB values ranged from £76,038 to £114,743, whereas the BMA recommended range was higher, with values between £85,514 and £125,262. This would be for a salaried GP working 37.5 hours a week under the terms of the salaried model contract (which includes 4 hours of CPD per week).
For comparison, the salary for a consultant in 2025/2026 was £109,725 rising to £145,478 for those who had completed 14 years as a consultant. National Clinical Impact Awards of between £20,000 and £40,000 would be in addition to these figures. The question was often asked: why is consultant remuneration so much higher than that for salaried GPs?
We have been told that at the inception of the NHS there was general agreement that career earnings for GPs and consultants would be the same. If partnership was the only route to being a GP, and there were feedback mechanisms on yearly drawings to enable this agreement to hold true, with government funding being regularly adjusted as needed, we would not have a problem.
The sessional GPs committee would never have come into existence either. But as we do have salaried GPs now, and our committee does exist, we must work to fix unforeseen problems. The motion passed by committee in February seeks to do this.
What the motion means
The first part of the motion is a statement of fact. It should not be controversial. Consultants and GPs have both been through similar medical training and, in more recent years will have been granted CCTs (Certificates of Completion of Training).
The length of training and the degree of service provision may have been different (as is also the case with numerous specialist training programmes) but this becomes less significant as the CCT date moves further into the past. Both categories of doctor will take clinical responsibility for the care of their patients. Both are able to prescribe. The equality of status comes from that ability to act autonomously, for the good of the patient, in a highly regulated profession that has, in the words of the GMC, ‘principles, values, and standards of professional behaviour’.
The second part of the motion is about equal remuneration within general practice for GPs doing clinical work. The employment status of the GP doing the clinical work (be they partner or salaried) should not influence the remuneration received for doing the same type of work and it should not influence the central funding that is made available to allow this clinical work to occur. The profit (in respect of risk and additional workload) for partners does not need to be directly tied to the amount of clinical work done. If all clinical work was remunerated equally we’d have the groundwork in place for achieving pay parity.
The third part addresses the costs associated with engaging GPs and that those costs will, in part, depend on whether clinical work is done by a partner or by a salaried GP. Employer national insurance contributions (at 15%) are payable by employers on employed earnings but not on partnership drawings. Appropriate remuneration for general practitioners should not rely on their being partners to obviate the need to pay employer’s national insurance contributions.
The funding settlement from government must account for varying downstream costs. It is not acceptable, in our view, to have to take on unlimited liability to be paid appropriately for the clinical work being done. Unless some form of adjustment is created to allow for the 15% employer’s national insurance costs to be funded, we will persist with an artificial ceiling in salaried GP income, with a step change in pay (and risk) requiring a move to partnership.
We have seen the new direct to practice reimbursement scheme operating through the SFE (Statement of Financial Entitlements). It should be possible to use a similar mechanism to account for the additional employer’s national insurance costs for salaried GPs that would not be payable should those GPs be partners.
The fourth part reflects the existence of the consultant pay scale and how, as an off-the-shelf system, it could be copied by government to be used in general practice. It would enable those in salaried GP roles to have instant equivalence in remuneration with their consultant colleagues (including NHS pension benefits). Additional awards could be discussed later.
The fifth and final part makes it abundantly clear that such a pay scale could only operate with suitable reform of the current GP contract, as funding mechanisms would need to be created to allow it to occur, with payments to practices being linked to the experience of the GP working there. Consultants’ pay regularly rises with experience and years worked, GP contractor remuneration tends to be static, which, should career earnings still be comparable, would mean contractors earn more per year than consultants in earlier parts of their career and less per year in later parts of their career.
The above motion quietly entered Part 2b of this year’s UK LMC conference in the section ‘Funding principles, pay/DDRB and resources’ The agenda committee had deemed it ‘unsuitable for submission to the UK LMC conference, due to not being specific or relevant to general practice or due to procedurally invalid wording’. Each part is standalone and captures an aspect of the problem and a potential solution to the pay disparity we see between consultants and salaried GPs.
Next steps for the motion
The sessional GPs committee will take this motion forward. We would expect that at every meeting held with government, regardless of sessional GPs committee representation, the policy formed by this motion will be worked through and solutions found to allow implementation.
Assuming we get headline agreement, and a suitable funding mechanism to allow for this, the work will then progress to tailoring any remuneration to the specifics of working in general practice. This work will ensure career earnings will truly be equal for all GPs working in general practice when compared to their consultant colleagues.
This issue is of great importance to salaried GPs. Earlier this year, shortly after the DDRB announced the 2026/2027 uplift recommendation of 3.5% for salaried GPs, the sessional committee put several questions to sessional members via a text message survey. One question asked about whether salaried GPs should have pay equivalent to consultants.
From 1287 responses across the UK, 86% agreed that they should indeed have pay equivalence. This aspect of our recently formed committee policy has clear support from our members. The equivalence of pay for an equivalence of status, particularly when considering clinical work where full responsibility lies with the GP or consultant for the care of the patient, is an easily understandable point of principle.
For too long this principle has been off the radar and therefore has simple never been addressed. It is an unforeseen consequence of the 2004 GMS contract reforms and must now be addressed, wherever a GP is employed to do clinical work, be that in a GMS, PMS, or APMS practice, or in an out of hours setting. We know GPs working as medical examiners are paid on a par with their consultant colleagues so it is only a matter of time before the lack of equivalence becomes impossible to justify. As a priority, funding mechanisms must be developed by government to enable pay equivalence to become possible.
We have seen improvements in pay and conditions in other parts of the NHS. The time has come for salaried GPs to have their value recognised by our country and sufficient funding made available by government for appropriate remuneration.
Mark Coley is an executive member of the sessional GPs committee