GP TechLead

The proposed 1.9% uplift to the GMS contract in England has ignited concerns within the general practice community, raising critical questions about its impact on both financial sustainability and patient care. Examining the details of this offer and its potential ramifications reveals a complex scenario with far-reaching consequences. 

The global sum for GP practices in England has been increased from £102.28 to £104.73 per patient, in order to finance a 6% staff uplift. This is roughly a 2.4% increase. Negotiations between the Department of Health and Social Care and the British Medical Association (BMA) concluded last week, and the BMA's GP Committee said they had done so 'satisfactorily'. The global sum is a fixed amount of money that GP practices receive per patient registered with them. It makes up the majority of a practice's income, and is used to fund all aspects of primary care, including staff costs, premises, and equipment.

On the GP social media, locum GPs are angry that they are unable to find jobs because other allied healthcare professionals are undercutting them. Locum GPs are fully qualified GPs who work on a temporary basis, and they are often used to fill gaps in the workforce when a GP is on leave or sick. However, in recent months, there has been a growing trend of allied healthcare professionals, such as nurse practitioners, paramedics and physician assistants, taking on GP roles.

Lots of interesting news came for doctors this week in the form of the Budget and also an announcement from NHS England. Jeremy Hunt, the current chancellor of the Exchequer who is control of the countries finances, was previously the infamous health secretary who battled the junior doctors back in 2016. Since then though, he has claimed that he more sympathetic to doctors and has claimed that he will solve the NHS pension issue for high-earning doctors. Well in this announcement on the 15th March has gone some way to solving it.

With the whole NHS seemingly crumbling, it wouldn't be a stretch to say that primary care was valiantly holding up a failing system. Emergency departments with long waiting times, paramedics, physiotherapists and nurses striking, junior doctors likely going to strike, waiting times for elective procedures at all time highs - there is only so much this system can take. 

Money is seemingly what is forever talked about in the news. We're constantly told we're in the cost of living crisis and that we're only steps away from the breadline. There are a few reasons for this, the war in Ukraine, the Covid pandemic and the period of relative boom with historical low interest rates. Those used to super low mortgage rates of less than 1% are now shocked that they are coming back to 'normal' interest rates of 5-6%. However it's not just mortgages that are now more expensive, it's everything such as milk and eggs. This has lead the inflation rate for this month to top 11.1%, the highest its been for 41 years. This makes it hard for us to afford everyday items as our wage has definitely not gone up by that amount. This disparity has led to the many strikes that have happened this year (trains, royal mail) and may lead to more in the next few months (nurses, doctors). 

Everyone is striking these days. The train drivers are always doing it. The posties are doing it this month. There are barristers and firemen talking about striking. More interesting in our case is doctors. The government has reccommended a 4.5% pay increase to doctors. However, not to all doctors. GP partners and doctors in training are not included in this deal. 

For most NHS workers, especially doctors, there may be less consideration for financial planning for retirement. There may be a thought that the NHS pension will be enough and actually with annual allowance considerations for high earners, further contributions will be not tax efficient. However there is another savings vehicle that could be used that seems to be often ignored for retirement, that is the Lifetime ISA (LISA).

Been busy with life so not posted for a while, so much has happened in the world since I last posted. Putin has gone true megalomaniac and invaded Ukraine, and if reports are true, they are doing a valiant job holding him back. Things were already very expensive prior to the war due to Covid but with sanctions flying from the western nations to Russia, it has made things like petrol very expensive. Certain foods are also set to rise, with the bulk of sunflower oil and wheat coming from these two countries, things like bread and livestock which need as feed, will become more expensive. Drivers have already noticed, with petrol prices through the roof, I'm sure we're a few weeks away from 200p / litre. Rishi Sunak tried to stem this tide with his announcement today, increasing the NI limit and taking 5p off fuel duty. Covid seems like a long lost friend...

The annual allowance allowance calculation for the NHS pension is confusing. I wrote about it here but I still have to go back to refresh my knowledge about it. The hard bit about working it out for tax purposes is to think that it's not the monetary amount you contribute, but its the annual growth of the your pension pot. The maths involved makes my head hurt. 

As I write this, I'm stuck awaiting a PCR test for a cough that has come about suddenly. I'm sure it's not Covid but got to make sure, the numerous lateral flows are all negative. It does mean that I'm away from any family this Xmas as PCR test results are taking the maximum 72 hours to come back; previously it was no more than 24 hours. Must be a combination of the extra testing this time of year, the increase cases due to Omicron and possibly less people working in the labs this holiday season. Omicron cases hit over 120,000 cases a day which is mind-blowing, no doubt some form of lock down will happen post-xmas. 

GP Practices have had a few financial obstacles put in its way this year. Firstly there was the 3% pay rise for staff which I have covered before. But more recently, there was an increase in National Insurance (NI) contributions and in the budget last week, an increase to the minimum wage to £9.50 an hour. Financial experts feel the NI changes alone will mean an average loss of £15,000 a year  to the average GP surgery. I feel NI is a very confusing tax to understand compared to income tax, so I thought I'd try to break it down as easily as I can.

Going back to my previous introductory  NHS pension post , employee contribution to the NHS pension was tiered dependant on your earnings. Below was the previous banding and employee contribution rates. 

Previous I discussed the principles of Financial Independence, Retire Early (FIRE) but there is more than one type of FIRE. There is a no one size fits all when it comes to financial independence. 

What is the point of saving? For some it is to buy a house, for others its to buy a nice car or a big holiday. But once you're settled in your living arrangement or there is nothing material to save for, what else should you do with your money? Do you live to work or do you work to live? These deep questions may make you think about the purpose of work and what we really do with our money.

I don't read the Daily Mail regularly but occasionally I get sent a interesting news articles by friends and colleagues. This time, I got sent the annual GP bashing article as the annual pay report is released, titled Rise of the £100k GPs . The actual financial report is published here . 

I briefly mentioned the proposed 1% pay rise for NHS workers in the maternity pay post but now the government has actually come out that there will be a 3% rise for NHS workers  in England. This will include consultants, dentists, nurses, paramedics and salaried GPs. This will not include doctors in training or GP partners however. This is actually more than I thought it would be, but for some, they want more. Consultants are being balloted to see if strike action is warranted as they didn't get the 5% they were looking for. Nurses will get roughly £1000 extra annually on average but they wanted 12.5% (which would be £4000 extra) and may strike as well. Other union NHS staff may also stage a strike if they don't get the pay rise they want.  Seems a bit ungrateful this sign A lot of their arguments are that it's still a below inflation pay rise (which is predicted to go reach near  4% this year ) and wont make up for the years of below inflation or non-existent pay rises.

As a member of the BMA, I occasionally get promotional emails from them and their partners. One such partner is Chase de Vere, an independent financial advisor. They send out regular notices of their free webinars talking about retirement planning, wealth building and investment advice, which can be be quite interesting to watch. However one such email invited me to get a free 'financial health check' - this seemed too good to pass up! I thought I'd go through what happened during this health check, and to remind you that no company gives you something of value that is truly free. 

One of the ways to become financially independent is to generate income whilst you sleep, passive income. The idea is that you invest either some time or money into a certain idea or thing, and that will generate income for you without any further time or effort. This is how generally the super rich, got super rich. People only have a finite time in which to earn (governed by how much you stay awake) so if you can earn whilst you sleep or do something else, that is the dream of many people I'm sure.

Cryptocurrency is the new financial trend at the moment. One month ago, it was at new record highs, with Bitcoin and Ethereum each having peak market caps of $1.1 trillion and $470 billion respectively. However in the last 7 days, a crash occurred which wiped 50% off their respective market caps. This volatility is part and parcel of cryptocurrency and I don't see this ending any time soon. But I do see some cryptocurrencies breaking out and sticking around for the long term, it will all depend on their fundamentals, institutional adoption, governmental regulation and ease of use. One of these is Bitcoin (BTC), and below I'll go over why I think it could possibly stick around for the future, and possible reasons why it wont.  The blockchain If you transfer some cash such as £100 from one bank account to another, a bank or financial institution is doing all the back-end work. It has to check a private ledger of your account; to make sure you have £100 then possibly contact the