The Department of Health has begun its clawback of the controversial minimum practice income guarantee by accepting a pay recommendation for GPs that would give practices an average net increase of 0.2 per cent.

The move came as other NHS staff groups were offered a three-year pay deal worth 2.75 per cent this year, 2.4 per cent in 2009-10 and 2.25 per cent in 2010-11.

GP practices have been offered a 2.7 per cent increase this year, but the Review Body on Doctors’ and Dentists’ Remuneration recommended that it should be funded by redistributing up to£90m in guaranteed funds currently enjoyed by practices in prosperous areas.

The recommendation represents the first attempt to cut down on so-called “correction factor” income guarantee payments to GP practices that were introduced in 2004.

Last month HSJ revealed that the guarantee led to inequity across the country, with huge variations in payments to practices regardless of the number and need of their patients. As most practices receive correction factor payments - of varying sizes - the change will result in a net increase to average core practice income of 0.2 per cent.

Philip Grant, core negotiator for NHS Employers, told HSJ the body’s recommendation recognised “the inequitable variations in GP income caused by the guarantee”. “We know that lower-earning GPs tend to be those in more deprived areas where patients suffer poorer health and whose needs are greater,” he said. “This announcement helpfully goes some way towards reducing those inequalities.”

British Medical Association GPs committee deputy chair Richard Vautrey said the average 0.2 per cent increase in practice pay was “derisory”.

The BMA is also unhappy that the pay offer to junior hospital doctors does not include compensation for the loss of their entitlement to free accommodation.

Other NHS staff groups welcomed their pay offers, which were substantially higher than the 2 per cent target set by the Treasury last year. Unison and the Royal College of Nursing both said they would recommend their members accept the proposed three-year deals.

A joint statement from other unions including Unite, the Royal College of Midwives and the Chartered Society of Physiotherapy, said they would accept the recommendation of 2.75 per cent for 2008-09 because of their commitment to the pay review body process.

However, the statement expresses concern over the proposed 2.4 per cent and 2.25 per cent offers for next year and the year after respectively, arguing that these may result in “a real-terms pay cut for our members”.