To think this budget will finish us off

[BurnoutGP]

I am a GP Partner of over 20 years. I am now senior partner for the last few years. We have seen year on year below inflation funding increase. With an explosion in demand and massive shift of work from secondary care. We have issues wirh recruitment.
Our partner income is shrinking year on year. We are now always overdrawn and this gets worse every month.
We just cannot soak up the MLW and NI without adequate resource uplift.
I think we will be done. I'm so very tired of the constant battle and the demand and anger while working "part time" 60hr weeks.
We will have to hand back our contract. And we wont be the only one. That will leave one surviving practice in my area.
I'm done.

You’ve got to be having a laugh, most nursing and clinical staff are on a Band 5!

This. There are lots of opportunities for progression. I know a nurse who qualified in 2019 who is now Band 7. There’s no way the Aldi worker could achieve this.

@BurnoutGP do we yet know what Wes Streeting's plans are for primary care? And how the NHS uplift will be spent to support a shift from acute to community settings?

The budget is just the headlines and the reality is the detail needs to float through. Some of it won't survive contact with water, so my advice is to get onto RCGP and BMA see what their views are. I would hope in practice this will not be as bad as feared right now.

Er, that’s true, however, we also got to see the ones who weren’t referred in a timely manner (personal experience of this!) but it’s not only cancer, other illnesses also…not missing any points! Often an examination done in the surgery would at least have been a pointer to the problem. Of course, now, in my area, we have barely been able to get a GP appt since March 2019.

@Sadjob band 5 isn't just for clinical staff. It's about the complexity and responsibility of the job.

Not quite sure why this is in response to pointing out why GP practices need to make a profit. I presume farmers work on that basis too - living off profit rather than taking a salary? Of course higher NI will impact profit and therefore income of many business owners possibly making them unviable.

@GillBeck people don't always get benefits on min wage. I don't

Are you a doctor working in secondary care too?
With respect, you don't seem to have much idea what is going on in General Practice, which is surprising if you are indeed a doctor.

I’m in the NHS. my wages have gone up around 17% since 2020. You are deluded if you think average wages have increased 40% in 5 years. Huge numbers of people have seen a real terms pay cut.

But you have spectacularly missed the point which is an employer, of any size, will have seen an increase in their wage bill. Employers in retail, hospitality, distribution, food production, healthcare and childcare will have seen disproportionately higher percentage increases on top of every other aspect of their business being squeezed because they are sectors that employ a high proportion of their staff on under £1-2 above minimum wage. They are also industries which have a real impact on the living expenses of people on low wages. Employers who mainly employ “professionals” will have seen an increase but it will be proportionally smaller even though the actual wages of individuals will be higher. Employers have budgets for wages and many will not absorb these costs, but will instead reduce staff hours or staff numbers or close altogether. It’s not about the rights and wrongs of the amount, or how nobody could run a GP practice without a cleaner, it’s about the sustainability of tax paying, wealth generating, private business increasing a sector of their expenses by 40%, then adding on additional taxes in the form of employer NI contributions and the stupidity of pretending this won’t have an impact on the viability of the private sector (somehow lots of people on this thread are absolutely fine with public sector employees getting paid close to minimum but not anyone who works in an industry that someone somewhere might make some profit on - even if they are actually not)

This is the case for most small businesses, without whom there will be no growth in the economy.

And I dread to think of the impact on the private care industry who already run on a shoestring.

Brexit might have been a democratic decision but it's also one that's cost the country billions.

We would be in a better state today if it hadn't happened.

Yes and in the hospital I work in, most admin staff other than apprentices are on band 4. I’m band 7 and recruit and manage band 4-5. Receptionists generally have additional duties and are multi-skilled and hugely valuable. Yes there’s band 5 nurses but a gp surgery cannot work without the admin staff.

And can it really have been democratic when it was sold on lies?

Disappointed with the budget but not surprised.

Farming is finished in the UK. The only hope I have is most of us can cling on until a new government comes in who can hopefully turn policy back around.

Heartbroken.

Not sure why you're surprised that these staff are - experienced and qualified level 3 staff in excellent nurseries are on around NMW too. I think many people are

Nope, nor do I! (Or any of my colleagues!)

No apparently her husband used to be a doctor 🙄

Hopefully this message gets to you. Your accountant is telling you politely to close your business. So close the business. you cannot afford to keep this practice going. The NHS must stand on it's own two feet and be invested in, and investing properly. This new budget is just the straw that broke the back. It isn't the cause. The cause is chronic under investment since at least 2008. It is either that or massively streamline and only provideprofitable (or break even) services.

It didn't fail because of you. It failed because of how the NHS pays for the services.

OP I feel for you. During my uni days I worked the front desk of a GP practice and got close to the practice manager and partner. Sounded like such a stressful job, honestly I don’t know how you manage to see patients AND run everything behind the scenes. I have so much respect for you all.

thanks for all that you do despite the rather crap circumstances. As a patient you are rather naive to these things.

I don’t know how you manage to see patients AND run everything behind the scenes.

They do this by paying highly experienced practice managers who need to be paid more than Band 5.

If they are losing £10k a month there will come a point where they will be insolvent and have no choice.

But why do you think they are having to do this?? It drives me crazy people like you forgiving the past government for driving the country into the ground to their benefit. You payed for rishi sunaks private jets and don’t complain about that. Madness

I know a nurse who qualified in 2015 and was a band 8a within 5 years. He's male which made a difference I think and he went for jobs which no-one else ended up applying for so shot up the ranks.

He's band 8b now.

Because when you've committed not to raise tax the best way to raise taxes is to push more people into paying taxes?