Three reasons why the Increase in Employer NIC costs must be cancelled for GP practices…… The bulk of GP Practices expenses are for employment - anything between 60 - 80%. The increase hits GPs disproportionately. So as GP partners their choices are 💰💰bear the cost - and accept some practices will close and in the meantime the Treasury loses the tax on the profits they are not making 💰💰cut costs - which has to be staff - and the service is diminished 💰💰💰outsource functions normally handled by staff, (back-office, admin etc) and replace salaried GPs with locums - which mitigates against developing a longer term strategy for the practice And the most surprising part of this? Our shiny new Health Secretary vacillates from saying GPs are not formally part of the NHS, then telling them to hold tight…and no time did he and our new Chancellor not predict this?? My new mantra - how is it we deserve such ineptitude from our leaders?
Lots of good comments here but the question I want answered is how between Rachel Reeves and Wes Streeting was this issue not thought through in advance of the budget. As we watch the pathos of refusals to help followed by advised to hang tight, don’t we need more than just making it up as they go along? I heard the new Environment Secretary interviewed by Evan Davis urging farmers to get Inheritance Tax planning advice to avoid the new tax charges. Have I stumbled into a new episode of Yes Minister???
GP practices are profit maximising private sector entities, just like any other private company. That their main customer is the NHS doesn't make them part of the public sector. The government should scrap the nonsense of having privately owned practices with duplicative administrative functions and instead renationalise them, and make all GPs salaried to create better economies of scale.
It’s not ineptitude, it is design.
Any business with a fixed contract is in the same boat as GPs. Including lots of businesses serving the public sector. Result is either lower levels of profit for directors, a need to cut costs or find additional revenue. IMO aim has got to be to find ways to cut costs but not reduce service levels - for example better adoption of digital tools can achieve this quite easily at times. (Side point - switching salaried to locum GPs would almost invariably INCREASE costs given locum sessional rate is a factor higher than salaried sessional rate). The elephant in the room is - does the government ultimately want to enfranchise primary care?
In his “letter to the profession” yesterday nowhere has Wes reassured us that this will be reviewed or reimbursed. He states that he will be negotiating our contract in 25/26. The outcome of such ineptitude and ignorance will be the loss of GP practices to larger APMS contract holding companies. He has effectively started to cull the part ship model behind the guise of inheriting a 1000 billion (the number keep rising🤦🏽♂️) black hole. I for one am tired to fighting for something no one else seems to want to fight for.
The impact of increased NIC costs on GP practices is deeply concerning. The options left for GP partners are a lose-lose situation that only exacerbates the pressure on an already overstretched system. It's essential for the government to rethink this decision and offer practical, sustainable solutions for GPs that ensure both quality care and the long-term viability of practices.
Laurence Slavin Spot on! The NIC hike feels like another blow to GP practices already under immense pressure. Cutting staff or outsourcing might keep the doors open short-term, but it undermines patient care and long-term stability. Decisions like this show a real disconnect from the realities of primary care.
Crazy times indeed. I'm surprised that even the current inept bunch haven't listended to the feedback re impact on GP's and made an adjustment. Either don't care or unable to process feedback that doesn't align with their dogma.
Take this as an opportunity to usher primary care into free market.
Partner at Ramsay Brown LLP. Chartered Accountants specialising in the finances of GPs, Hospital Consultants, Author (How to Manage your GP Practice - Wiley), Problem Solver, Expert Witness in GP Disputes, Educator etc
3wAnd you know what comes next…..it’s the partnership model that’s responsible! Such nonsense