Doctors and Dentists Remuneration Body: Government Response

I am responding on behalf of my right hon. Friend the Prime Minister to the 48th report of the Review Body on Doctors’ and Dentists’ Renumeration (DDRB). The report has been laid before Parliament today (Cm259). I am grateful to the chair and members of the DDRB for their report.

This report has been produced during what is an incredibly challenging time for our NHS and the DDRB report rightly recognises the tremendous effort of all of our clinical staff on the frontline of the covid-19 response. They have shown true resolve, professionalism and dedication throughout this challenging time for our NHS.

Thanks to the Government’s investment in the NHS and the certainty provided in the long-term funding settlement, the Government are pleased to accept the DDRB’s recommendations in full, providing a much deserved pay rise for our doctors and dentists working across the NHS.

The Government greatly value and appreciate the role public sector workers have in delivering essential public services, and we are delivering a real-terms pay increase to show that we mean it. The hard work and dedication of our public servants are something we do not take for granted.

We are conscious that public sector pay awards must deliver value for money for the taxpayer. Covid-19 is having a very significant impact on the economy and the fiscal position, and the Government will need to continue to take this into account in agreeing public sector pay awards. It is important that public sector pay is fair to both public sector workers and the taxpayer. Around a quarter of all public spending is spent on pay and we need to ensure that our public services remain affordable for the future.

Today’s pay award is worth on basic pay:

Between £2,200 and £3,000 for consultants

Between £1,100 and £2,100 for specialty doctors

Between £1,500 and £2,600 for associate specialists

This Government have invested heavily in our NHS and its workforce. We have backed the NHS by passing the NHS Funding Act which enshrines in law the largest cash settlement in NHS history as well as clearing billions of pounds worth of debt for NHS trusts. We also pledged that all public services would get whatever financial support they needed to deal with the covid-19 pandemic and we are working at pace to ensure the supply of vital funding and resources continues. We have also delivered on a manifesto commitment to address the tax issue in doctors’ pensions by listening closely to the concerns of senior clinicians. The Chancellor confirmed at Budget that both annual allowance taper thresholds will be increased by £90,000 from 6 April 2020, removing anyone with income below £200,000 from the scope of the tapered annual allowance. The incentive to take on extra NHS work is now restored, and clinicians can earn an additional £90,000 before reaching the new taper threshold. These measures will take up to 96% of GPs and 98% of NHS consultants outside the scope of the taper based on their NHS income.

The DDRB was asked not to make a pay recommendation for contractor general medical practitioners (GMPs) or doctors and dentists in training as both groups are moving into the second year of their respective multi-year deals. The significant investment in GMP core practice funding, as part of the five-year contract, provided greater certainty for GMPs to forward plan. The contract as agreed in 2019, and via further amendments in 2020, has also set out significant additional investment in a new state-backed indemnity scheme, the introduction of primary care networks and reimbursement for additional staff. For doctors and dentists in training the multi-year deal will mean all junior doctor pay scales will have increased by 8.2% by the end of the deal, and in addition circa £90 million is being invested to reform the contract, including to create a new, higher pay point to recognise the most experienced doctors in training.

Affordability has to be a consideration of Government when responding to the DDRB. Accepting the DDRB’s recommendations will require difficult trade-offs and reprioritisation of spending within the wider context of the original financial plan set out in the NHS long-term plan. However, the Government deem accepting the DDRB’s recommendations as important to reward and retain valued NHS staff.

In addition to retaining existing staff, the Government are committed to increasing workforce supply. That is why by September this year we will have opened five new medical schools in England so that we can continue to grow our domestic medical workforce. The new schools will help to deliver a 25% increase in the number of available places and by September we expect there will be an extra 1,500 medical students entering training each year, compared to 2017.

The Government’s response to the recommendations is as follows:

Accept the recommendation for a uniform 2.8% uplift in pay across the whole of the DDRB’s remit group with the exception of those already in multi-year deals. This includes uplifting the value of the GMP trainers grant, the GMP appraisers’ grant and the minimum and maximum of the pay range for salaried GMPs.

To accept the recommendation to freeze the value of national and local clinical excellence awards (CEAs), commitment awards, distinction awards and discretionary points.

For salaried GMPs the minimum and maximum pay range will be uplifted. As self-employed contractors, it is largely up to GP practices how they distribute pay to their employees. Employers have the flexibility to offer enhanced terms and conditions—for example, to aid recruitment and retention.

For specialty doctors and associate specialists (SAS doctors) the Government take note of the DDRB’s comments on the need for improved recognition and career development. Negotiations on a multi-year pay agreement, incorporating contract reform, for this group of doctors are progressing and we hope to reach agreement in time for the next pay year.

The Government also acknowledge the DDRB’s comments on clinical excellence awards and its reasons for not recommending an increase in their value. With this in mind, we will progress our plans to reform these awards with a view to introducing new arrangements from 2022.

A 2.8% general uplift in the pay element of their contract backdated to April 2020.

The Government have also fully acknowledged the DDRB’s comments on the lack of progress on the dental contract reform and we appreciate the frustration with the pace of reform. NHS England and the Department of Health and Social Care need to be confident that the prototype contract, which has been tested, has proven that it has the ability to maintain or increase access, improve oral health, and is affordable for the NHS while also being sustainable for dental practices, before taking decisions on wider national implementation.

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