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Now NHS doctors handed cash top ups in a bid to stop early retirement

NHS trusts are now handing out cash top-ups to convince doctors not to retire early because of a controversial pension scheme

  • Curbs on pension allowances before huge tax bills has led to doctors quitting
  • Staff have been refusing extra shifts in order to avoid hefty sums
  • Trusts have used cash contributions to pensions as an incentive to stay

The NHS is handing out cash top-ups to doctors’ salaries in a desperate bid to stop them from retiring early.

Doctors are trying to avoid big tax bills from stricter pension rules that put a cap on their saving allowances. 

It’s led to thousands leaving the profession early, amid a worsening staff shortage in the NHS workforce. 

Around ten NHS trusts have now offered to contribute cash to doctors’ pensions so they can opt out of the pension scheme, the Financial Times reports.  

The NHS is handing out cash top-ups to doctors’ salaries in a desperate bid to stop them from retiring early because of the huge tax bills on pension allowances

York and Harrogate NHS trusts are among the organisations offering cash top-ups to salaries to senior doctors as an incentive to stay. 

‘Our trust has an established scheme to support employees who wish to opt out of the pension scheme because of the lifetime allowance cap,’ said a spokesperson for the York Teaching Hospital NHS Foundation Trust.

‘We are in discussions regarding expanding the scheme to support those who wish to opt out because it is no longer economically viable for them to contribute if they would exceed the annual allowance by remaining in the scheme.’

Harrogate NHS Trust did not respond to a request for comment.  

Restrictions which came into affect in 2016 mean doctors who earn more than £110,000 a year enter a ‘taper zone’ which triggers big tax bills.

This can reduce the annual allowance – the tax-free amount workers can contribute to their pension – to £10,000 for those earning £210,000.


Official figures showed in February that 41 per cent of GPs – around 10,000 doctors – are 50 or over and are expected to quit within the next five to ten years. 

And 2.5 million patients are at risk of their local GP surgery closing because so many are relying on doctors who are close to retirement, it was last week revealed. 

At the same time, fewer young doctors are choosing to specialise as GPs and are opting for other career paths as surgeons or specialists. 

Many GPs are retiring in their 50s, moving abroad or leaving to work in the private sector, increasing the pressure on those who still work in the sector. 

Appointment waiting times are getting longer and more people are going to A&E for minor illnesses because they can’t see a doctor. 

Despite an NHS a plan to recruit 5,000 extra GPs by 2021, numbers of family doctors are falling.   

And 762 GP practices across the UK could close within the next five years, according to the Royal College of Nursing.

Rachel Power, chief executive of the Patients Association, last week told The Times: ‘This is a desperate situation with potentially serious consequences for patients.’  

It’s led to more than 3,500 doctors to retire early to avoid bills of thousands of pounds, the Government has admitted.

Patients are suffering delays to operations and cancer diagnosis as a result of staff turning down extra shifts in fear of being hit with a huge tax bill.

Other critical areas affected include intensive care and emergency wards, as well as radiology and pathology departments, according to The Financial Times.

The cash in lieu of pension arrangements would mean doctors don’t lose out on employer’s contributions, which are worth 20.6 per cent of the pensionable salary, when they opt out of the NHS pension scheme.

The health department are aware of the situation, and the doctors’ union the British Medical Association said they want it made a national policy.  

Vishal Sharma, a senior official at the BMA, said: ‘The pension tax issue is a big problem for staff. 

‘We are keen to avoid the situation where staff will be migrating to hospitals where they do have flexible arrangements.’

Official figures showed in February that 41 per cent of GPs – around 10,000 doctors – are 50 or over and are expected to quit within the next five to ten years. This is up from less than a third (32 per cent) in 2014. 

Meanwhile, almost a fifth (18 per cent) said they would leave or retire within the next two years. 

GPs are blaming increasing workloads and declining morale with half admitting they have brought forward plans to walk away from the vocation.  

NHS staff shortages in England have hit more than 100,000 positions, according to three think tanks, the King’s Fund, the Health Foundation, and the Nuffield Trust.

They predict that the situation could increase to almost 250,000 by 2030 if not dealt with.

A workforce under such pressure would substantially undermine the ambitions of the NHS long-term plan, which was published in January, they said.

It would further exacerbate the long waiting lists and diminish quality of care, the experts warned.  

A Department of Health and Social Care spokesperson said: ‘We recognise the tax implications of the annual allowance and its impact on high earners in the NHS.

‘We keep public sector pay and pensions policy under continuous review and are talking to the Treasury about this issue, listening carefully to senior doctors and NHS employers.’ 


More than 2.5 million patients across England could see their GP surgeries close in the next five years, experts revealed in November.

The Royal College of General Practitioners said 762 practices in the UK are at risk of closing within the next five years because at least three quarters of their doctors are aged 55 or over and approaching retirement.

Experts said so many closures would have a ‘catastrophic’ effect on the health service. 

Appointment waiting times could get even longer, workloads would grow and more people could end up queueing at A&E for minor illnesses.

Campaigners warned the potential closures would be ‘dangerous’ for patients and are calling for ‘drastic action’ to encourage new GPs to join the profession.

The situation is worst in Southend in Essex, where 13 of the area’s 35 GP practices are at risk of closing, potentially affecting nearly 39,000 patients.

A third of surgeries in the London borough of Havering could shut down, and more than 85,000 patients could lose their GP in Sandwell and West Birmingham.

Only around a quarter of areas of England have no practices at risk of closure, according to the RCGP’s estimates.

Figures from the Royal College of General Practitioners have revealed 762 GP practices across the UK are at risk of closing in the next five years (Map shows the proportion of surgeries in each area which are at risk of closing)

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