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.

I’ve tried to find out about this. From what I’ve read the NHS will not be “exempt” as such but the Chancellor is going to provide the NHS with extra money to cover the increased payroll cost. I think it probably has to be done this way as otherwise it could creat distortions in the labour market? However this is just what I’ve seen online it’s not definitive.

When money is given to "the NHS" GPs and Dentists often don't see the benefit.

Yes I was just responding to the poster who said the NHS is exempt from the NI increase. I understand that certain GP’s etc are effectively self-employed.

All GPs are self-employed.

These threads are such a poor way to discuss the impacts as they use “real” examples presented in only the way the poster wants it presented.

i won’t quote them as they don’t want to discuss it further but the poster whose husband owns a vet surgery has been across a few threads talking about the £130k hike in business rates and stating it will cause her H will now go bust.
They have now volunteered, in this thread, that their sales prices are so low that in one example they were 60% lower than a competitor. In another they weren’t even charging for an extremely expensive out of hours service.

thats obviously a huge part of the reason the posters husband doesn’t think they can shoulder the hike on costs, they haven’t been charging enough to gain the revenue they could.
However, had they run their business in a more commercial manner, they would be unlikely to be in this bind.

of course, it wasn’t presented like that across all the threads: the extremely low sales prices were thrown in to show how much the public desperately need businesses like theirs.

No they’re not. Practices are increasingly employing salaried GPs.

Not certain GPs, ALL GP partners. This rant isn't at you but a general one, their staff are reliant on them staying solvent to pay their wages, including their salaried doctors and students who learn with them. Doctors and nurses getting payrises as per the headlines often doesn't filter down to them, because they're not on AfC. In order to stay competitive as employers though the practices often choose to salary and benefit match the main NHS but with less and less funding are finding they're are increasingly unable to do this, as the OP is sadly finding out.

Ok didn’t know that. Thought some were salaried.

BIossomtoes · Today 12:18

Unbelooth · Today 12:16
All GPs are self-employed.
**
No they’re not. Practices are increasingly employing salaried GPs.

This. Ours is a group practice, 3 partners, 5 “staff” GPs.

They are. It’s not true.

All practices are stand-alone businesses. Not part of the NHS.

That doesn’t mean they don’t employ salaried GPs.

Indeed. But none of those salaried GPs are employed by the NHS. They are employed by the self-employed GPs who run the practice.

Okay. In that case, she's bound to know far more about current general practice than current GPs right! Makes sense. 😄

You said all GPs are self employed. They’re not. Just admit you’re wrong, we’re all wrong sometimes.

Yes it hadn't occurred to me that some practices employ GPs, instead of them being partners.

None of them are employed by the NHS, though.

There are some GPs directly employed by the NHS - normally in areas where there has been a ‘market failure’ of GP services so the NHS has had to step in to fill the gap. The NHS usually looks to exit from this arrangement as quickly as possible though by bringing in another GP practice or provider of GP services.

If they came under Trust management then they would.

Is there a spare room that could be let out at the surgery? One big enough for a tattoo remover to operate? I imagine demand for this service is only going to increase and clinical premises seem like a great place to be located. Or even a very reputable aesthetician?

In Scotland these are ‘2C’ practices

It's understandable you feel frustrated OP. There can be nothing more rewarding than saving a life, regardless of age. I hope your practice can find ways of becoming more financially viable. You sound like a wonderful & dedicated Doctor but your only human. Perhaps a lovely sunny & guilt free post Chrismas holiday is in order if feasible
🛫🌞💐

Just because you don't understand the implications of this budget on growth doesn't mean that those that do and are therefore vocal are having a hissy fit. And also, not everyone one is far / right (why is right' always linked with 'far' by the hard of thinking...?) just because they disagree with your point of view

Someone once said that trying to tax your way to prosperity was like standing in a bucket and trying to lift yourslef up by the handle. Even Blair saw that...and he bought his own clothes ;)

I am also a GP senior Partner and I couldn't agree more with the OP. This is a disaster for General Practice. To all those saying 'just take over all the practices' you clearly have no idea of the amount of good will that GP partners put into running their own businesses and how much pride most take in providing high quality health care. Take that away, and the good will will stop, overnight. Many of us own the buildings from which the NHS surgery runs, if you take away our contracts the NHS will either have to buy the building or we can sell it for development. Not sure where out 30,000 patients will be seen if the building disappears

If I become a salaried GP for a large NHS organisation, it will cut my workload , a LOT. All the weekends I spent vaccinating people against flu and covid, forget that, you will have to pay me. I wont work more than 37 hours a week and believe me, I do that in 3 days at the moment. However, it will also lose the continuity I have with patients, many I have known for 25 years, it will lose the tight organisation I have built where many of our staff are supported, trained and developed.

Im quite sure this is where its going , and honestly, come to me with an opportunity an I and my partners will probably take it. But I doubt it will be the NHS that comes calling. It will be Virgin health care, or United health or another big health care corporation who sees the opportunity to make money by replacing GP's with cheaper less qualified physician associates or pharmacists.

We don't employ 'cheap' alternatives to GP's because we don't believe that a PA with a 2 year degree has the breadth or depth of knowledge to see people with undifferentiated problems and consider all the possible diagnoses. Hiring salaried doctors are expensive, but of our 95 staff only 25 are doctors.

we have a monopoly income provider, the NHS, a tight contract to work t; its forbidden to offer private services to NHS patients; we cannot increase income... most of us are already extremely efficient as regards waste etc, so there is no option to cut cost.

The only option will be to not replace the next GP who leave for Australia.

All the weekends I spent vaccinating people against flu and covid, forget that

I had my flu and covid vaccinations at Boots. Is it really sensible for GPs to be doing this low level stuff? It’s a prime example of how money could be saved.

It makes money for the practice, and because my time and that of my business partners is 'free' i.e. we do not get paid extra for it, its actually worth doing.

We also prefer to do it, or at least try to, because we are heavily financially penalised if patients in certain categories do NOT have a flu vaccine, and we are very often not informed if they go to Boots or somewhere else to have it. If we invite people, we know its been done