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How to approach Primary Care Network pay rises in 2023 and beyond

Updated: Oct 22

At THC Primary Care, we create resources and share lessons learnt to support Primary Care Network leaders.


In this blog, we tackle the topic of pay raises for Primary Care Network staff, answering some frequently asked questions covering;

  • Should the PCN, and general practice staff, percentage pay rise be the same?

  • What percentage pay rise should PCNs offer their team as part of their annual pay review?

  • How can PCNs fund pay rises if they take us over the current maximum reimbursable rates?

  • What should we include in our pay rise policy?

We also signpost you to the latest PCN Ready Reckoner and NHSE PCN DES.


Let's jump in!


Graphic in teal and white -how to approach primary care network pay rises in 2023 and beyond

Background


When this post was originally written, pay rises were a hot topic following the 19 July 2022 announcement of the government's acceptance in full of the recommendations from the independent NHS pay review bodies.

This meant that over one million NHS staff; including nurses, paramedics and midwives, were eligible to get a pay rise of at least £1,400 (with the lowest earners set to receive a rise of up to 9.3%). Dentists and doctors received a 4.5% pay rise.


What did this mean for Primary Care Networks?

As stated in the NHS England document; 'Supporting general practice, primary care networks and their teams through winter and beyond', it was confirmed that there will be an increase in the ARRS maximum reimbursement rate for 2022/23 to account for the Agenda for Change uplift.

This was good news for PCN staff. However, this news presented a challenge for general practices (who make up the network) as the Department of Health and Social Care (DHSC) reported that there will be no adjustment to practice funding, to enable them to adhere to the recommended pay increases for salaried GPs and staff.

This potentially furthers the inequity of pay between practices and PCN roles, as many practices:

  • Do not follow the Agenda for Change funding structure

  • Have different terms and conditions for practice and PCN staff

The funding mechanisms for staffing costs is also different.


This will not be the focus of this blog, but it's important to acknowledge.


Increased Reimbursement in 2023


On 2 June 2023, the PCN DES additional role reimbursement rates were updated and come into play on 1 July 2023 (see pages 60 to 73).


Please note the document states:

For the avoidance of doubt, the existence of the higher maximum reimbursement rates does not affect the overall value of a PCN’s overall Additional Roles Reimbursement Sum.

This means whilst the rates of pay go up, your PCN budget remains the same.


A snapshot of current and new reimbursement rates can be found below. Please click on each image to enlarge it.


Reimbursement Rates from 1st April 2023 - June 2023

A spreadsheet with ARRS reimbursement rate figures

Reimbursement Rates from 1st July 2023 - 31st March 2024

a spreadsheet with ARRS reimbursement rate figures

Full details are available via the NHSE PCN Ready Reckoner which is here.


The increased envelope for the additional roles reimbursement scheme is approximately 5%, but this does not mean all staff have to receive this increase. This is to be determined by the employer.


Also to note, on 13th July 2023, the Government announced that it would increase doctors' pay for 2023/24 by 6% (alongside pay rises of between 5-7% for other public sector workers, such as teachers, the armed forces, and prison guards).

This uplift to practices is intended to cover all salaried practice staff and not just salaried GPs, subject to consultation with the BMA, which the DHSC intends to commence shortly. This is separate from the PCN ARRS.

https://www.pulsetoday.co.uk/news/breaking-news/gp-practices-to-get-funding-uplift-to-cover-staff-pay-rise/

But again, the increase is not mandatory, and I believe this is to be determined by the employer.


Frequently Asked Questions


Here are some of the most frequently asked questions we are aware of (and are tackling in the networks we currently support) - and have had to work through ourselves.


💢 What percentage pay rise should PCNs offer their team as part of their annual pay review?

A number of factors will influence this.

  • How have your team members progressed based against performance objectives?

  • Have they taken on additional responsibilities?

  • Where does their current salary sit when benchmarked against other roles in the network, and neighbouring networks?

  • What is the pay rise percentage range being offered by practices within your network?

  • What is the available ARRS budget for each role and is there any additional funding available via other workstreams i.e. core funding, last year’s impact and investment fund, the leadership and development fund, etc.?

  • Rising inflation and its impact on the cost of living.

  • The recruitment trends experienced in your network to date.

From here, you will be able to ascertain what is fair.


💢 Should the PCN and general practice staff percentage pay rise be the same?

Not necessarily, but if you can, it would start to close the gap and reduce the potential for internal competition. There will already be a great range of salaries across the practices in your network, with the same role paid more in one practice, and less in another so different pay scales are not uncommon.

However, if your network roles are hosted by a federation which also manages practices within the network, or the PCN roles are hosted by an NHS organisation, the pay rise allocation should be consistent.

If the PCN has a separate structure from the above, you can agree on a different pay increase.

You can, of course, come to an agreement across your practices to maintain a consistent approach.


💢 How can PCNs fund pay rises if they take us over the current maximise reimbursable rates?

You can use the following funding sources:

  • Last year’s Impact and Investment Fund

  • The Core Funding

  • The Leadership and Management Fund

  • The Network Participation Funding

  • The Local Capacity and Access payments

  • Practice funds

On this point, it’s worth remembering that the PCN receives the funds to employ roles that can generate income for the PCN and practice. Many practices already subsidise PCN roles and see this as a valuable investment.


Work with your finance lead, who can help you with scenario planning and financial forecasting.


💢 Can I backdate a pay rise?


The 23/24 updated DES states:


The increased maximum reimbursement rates apply prospectively from 1 July 2023. Claims for any backdated increases prior to this date are not eligible for reimbursement.


💢Do I have to give my PCN staff a pay rise in July 2023 when they have already received a pay rise in November 2022?


Pay rises should be granted in line with your pay rise policy. Please see below for further advice on policy implementation. If a review of your current salary allocations is overdue, this is a good opportunity to do so.


💢 We want to create a pay rise policy but we are unsure of what to include. What would you include?


Firstly, I would recommend you contact a qualified HR expert but as a starting point, you could look to incorporate the following wording;


Pay Policy Introduction

Pay is one of the most important factors in our working life and is a sensitive subject. It is acknowledged that a fair and transparent process for allocating pay increases is required and this is the purpose of this policy.

Outside of direct pay, PCN XXXX aims to provide a work environment which is welcoming, provides flexible working and enables you to progress in your role, which is also factored into your employment package.

This pay policy is to be read alongside your contract of employment and the other HR policies that support your employment.


The % pay increase will take into consideration employee performance over the business year, cost of living increases and the available financial envelope.


Example of a PCN Commitment

  1. To provide continuous positive and constructive feedback on your performance.

  2. To ensure all employees will receive an annual pay review.

  3. To ensure monthly 1-2-1’s will take place, which will inform your annual pay and performance review.

  4. All pay rises are a reflection of the employee's performance over the whole business year.

  5. In the annual performance review, all employees will receive confirmation of their pay increase within the month of XXXX.

  6. If an employee receives a pay increase due to increased responsibilities part way through the year, this will be reflected in the annual performance pay increase.


Example of an Employee Commitment

The Employee is responsible for:

  1. Maintaining a consistently good level of performance at work.

  2. Attending work, ready to start at their specified time.

  3. Acting in a professional manner.

  4. Committing to their professional development.

  5. Fully participating in the process of managing their performance and working within your scope of practice.

  6. Ensuring they treat patients, colleagues and wider stakeholders fairly and equitably and in line with your professional code of conduct and terms and conditions of your employment.


Final thoughts...


💢 Allocating pay rises is always tricky so it's really important to be transparent. People talk, and inconsistencies can cause conflict and result in you losing key team members.


💢 Ensure your team understand what their pay rise is based on. They shouldn't be hearing about this for the first time in their pay review.


💢 There will never be enough money to go around for everyone to get exactly what they want so look at the whole employment package on offer. We must be fair and show that we value our workforce.


We hope this helps.

 

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About the Author


Tara Humphrey

Tara and Team THC provide project and network management and training to Primary Care Networks. Between our training programmes, facilitation and interim network programmes, we have now supported over 120 PCNs!


Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care, is the author of over 200 blogs and also hosts The Business of Healthcare Podcast.


Find out more about THC Primary Care at www.thcprimarycare.co.uk



 

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