Secret Diary - Finances, Flu and the Future

Our anonymous practice manager shares their thoughts on finance, flu and facing a glut of salaried GPs...

Using Our Voice

A few weeks ago I attended an election husting organised specifically to discuss the NHS in our area, and of course nationwide.

Four of the prospective MPs agreed to meet to enable closer inspection of their manifesto commitments to the NHS.

Although the meeting was arranged with short notice, over one hundred people attended - PPGs, GPs, Support staff, dentists, and the public.

The questioning was very interesting and some of the answers were enlightening, and I got a better insight into some of the things in the manifestos.

I am not going to say who said what, and what was not said, as I am sure you can imagine how the evening went.

The point I am making is that we do have a voice, and we can challenge things going forward, and we do need to hold others to account.   

It's fine to say record money is being invested into the NHS, but is it being spent well, and where is it going? As highlighted in the meeting, Primary Care does much of the work for a very small portion of total NHS funding.

Promises are easy to make but harder to keep, and whichever party gets in will be judged on results over the months and years to come.

So, do I feel any more assured that things will change after July 5th? To be honest, no.


As if things are not bad enough within primary care in England, we are being faced with incorrect GMS statements and payments missing or incorrectly paid.

I can accept occasional mistakes, but in each of the last 3 months, we have been underpaid. (Amazingly, we never get overpaid!)

I wonder if this is happening across the country?

We are not talking about small figures here, and for those practices that are in financial difficulties, this only makes matters worse.

We are all facing an increased wage bill, due to the increase in the minimum wage by 9.1% in April, but only a small increase in the GMS income of 1.9%.

So far, our general rates bill each month has been underpaid, and our enhanced services in June have not been paid, along with the training grant. Add to that the balance on our 2023/24 QOF payment is also delayed until July when we expected it in June, so it’s all adding up to significant monies.

Apart from the extra work this brings us, it just seems to me that this is a ploy by the NHS to delay their payments.

We haven’t even had the courtesy of an email from the NHS apologising for all this. I am not blaming the ICB as they have constraints just the same as everybody else, but again, we on the front line have yet another issue to contend with.

Flu 2024/25 season

Those of us who thought we had finally found a solution to the supply of just one Flu vaccine to cover everybody, must have been as shocked as I was to receive the news that there was a manufacturing fault, and they could not be supplied this year.

Fortunately, other companies were able to step in with the supply of two vaccines so at least we can vaccinate as before.

Now I do not blame the company these things happen, but how many of us will go for the one vaccine if it is offered for the 2025/26 season? I’m not sure we would, as it seems risky.

It looks as though a company is developing an all-in-one Covid/Flu vaccine which is an interesting concept.

However, that brings many other issues with it. What happens if a patient wants one and not the other? Would we need to stock different combinations?

It would certainly make the whole process far more complicated and not one we would sign up to at the moment.

GP Recruitment 

To think that we are now facing a glut of salaried GPs is just incomprehensible; from our own experience there has been no shortage of applicants to recent vacancies and weekly I get several emails from GPs looking for a salaried role.

There is a lot of talk that salaried GPs are being replaced by cheaper workforce like PA, PNS, etc but that cannot be the whole answer.

To think patients in some parts of the country cannot get to see a GP when we have a glut is worrying. The reduction in real terms of finance into primary care has led to many practices having to either cut jobs or look at a different skill set.

I can only talk of my experience and that is we have a PA, but they are only able to do certain things, and do not replace a salaried GP.

The cost of taking on a salaried GP is high, and our income justifies how many we can employ, and if it creates stress on the finances, we have to say no.

It is the NHS and the Government that must look at whether they are to blame for this crisis and explain their funding model. It is outrageous that they train doctors up and when they qualify there are no jobs and yet patients could benefit from these doctors when primary care is on its knees.

To blame the situation on Physician Associates etc is wide of the true facts and alienates patients and doctors.

Created by Secret Diarist
Secret Diarist
FPM's Secret Diarist and Anonymous Practice Manager gives us their views throughout the year on the latest developments in primary care, what they think of the powers that be, and any other bugbears they need to get off their chest...


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