Faced with an impasse in our negotiations with the Welsh Government, we mutually decided to conclude negotiations for this year without a negotiated contract agreement.
However, this impasse, where Welsh Government had not released any uplift to practices for the current financial year, could not continue indefinitely without further exacerbating the sustainability challenges being faced by Welsh practices across the country.
Consequently, a sum of £20 million has been invested into the GMS contract for 2023/24. The Minister maintains this to be the maximum available financial offer.
To put this into perspective, this quantum of £20 million pounds represents 4.4% of the GMS Contract value of £450 million.
The Welsh Government, NHS Wales and GPC Wales were engaged in tripartite negotiations for the GMS Contract 2023-24 from September 2023. The beginning of negotiations was delayed at Welsh Government’s request due to the significant budget challenges they encountered in summer 2023.
The ongoing BMA Cymru Wales Save Our Surgeries campaign clearly outlines general practice's longer-term challenges and the need for a wider debate about the key asks of the campaign.
While our view remained unchanged, zero-investment for the 23-24 financial year into GMS would be irreversibly damaging to practices. This impasse, where Welsh Government had not released any uplift to practices for the current financial year, could not continue indefinitely without further exacerbating the sustainability challenges being faced by Welsh practices across the country.
As outlined in the Ministerial Statement of 7 February 2024, this was acknowledged by the Minister and her officials.
Financial changes
The funding uplift arrangements for 2023-24 have been invested by Welsh Government into the GMS contract as outlined below.
| Contract element | £ (m) |
|---|---|
| GP pay uplift (To 38.6% of contract value) | 8.7 |
| Staff uplift to staff portion of 39.3% (Being 64.1% of the remaining 61.4% of contract value) | 8.9 |
| Total Pay Uplifts (NB: Rounding) | 17.6 |
| Other Expenses | 2.4 |
| OVERALL INVESTMENT INTO GMS CONTRACT | 20 |
| Global sum | Per weighted patient |
|---|---|
| Global sum 2022/23 | £114.40 |
| New global sum for 2023/24 (Backdated to 01/04/2023) | £117.48 |
Associated contractual changes
None.
Passing on the staff pay uplift
Recognising the vital role all practice staff play in the delivery of services and the desire for a fair and equitable pay uplift to be made to those existing staff, funding has been made available, mandated to ensure all existing practice staff receive a 5% uplift to their gross pay.
The requirements are as follows:
All staff that were in post at 1 April 2023 should receive a pay increase of 5% for 2023/24, backdated to 1 April 2023.
- Where practices have already awarded staff an in-year pay increase, they must now uplift that increase to 5%, if it was previously a lower figure (e.g. staff already awarded 4% must now also get the additional 1% backdated to 1st April and applied to the rate payable on 1st April - not the uplifted rate)
- This will include any staff that may have left practice employment since 1st April 2023 and practices should make reasonable attempts to contact those staff that have left.
- New staff that started in post after 1st April 2023 may be subject to specific clauses in their practice employment contracts in their first year of employment. Practices will need to make a judgement on these on an individual basis. Practices will be required to complete a self-declaration to their Health Board, as in previous years, to confirm that they have paid all eligible staff a 5% pay rise.
"2.4A. £2.71 of the figure of £117.48 in paragraph 2.3 is to account for the agreed 5% increase in annual remuneration to practice staff employed by the GMS contractor and which GMS contractors must reflect as at least a 5% pay increase for those staff beginning with 1 April 2023. The LHB may recover this amount from a GMS contractor in accordance with section 19 if it becomes apparent that the GMS contractor has not increased the remuneration of their practice staff by at least 5% for the financial year 2023/2024."The updated Statement of Financial Entitlements (SFE)
In addition to the SFE requirements as outlined above, the BMA Model Contract for Salaried GPs contains an expectation that an uplift is received annually in line with the DDRB pay recommendation. Practices will need to consider this factor if salaried GPs are employed under these terms and conditions.