GP partners have taken more profit from practices while their nurses and other staff have seen little improvement in their salary since new GP contracts came in, an official report claims.
The National Audit Office (NAO) study also found the pay and conditions agreements have cost £1.76bn more than the government predicted.
But nurses are now delivering more practice work, with the proportion of consultations carried out by nurses rising from 21% to 34% between 1995 and 2006, it added.
The study said: "Practice nurses and salaried GPs, who form part of the practice team, have not benefited to the same extent (as partners) with pay rises largely in line or indeed below inflation."
Dr Peter Carter, general secretary and chief executive of the Royal College of Nursing (RCN), added: "This report clearly demonstrates that general practice nurses have been consistently delivering high quality care as part of the general practice team, yet too many continue to be underpaid and undervalued.
"With an increasing number of practice nurses taking on more responsibility, it is only fair to expect that this extra work is recognised in their pay.
"With only 16% of GPs signed up to Agenda for Change (AfC), we reiterate our call for all GPs to introduce a fairer system of pay by implementing AfC, something which the British Medical Association general practitioners committee have previously called for."
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Should extra nursing work be recognised via extra pay? Please leave your comment, name and location in the feedback box below. Your details will not be published if you so request. Terms and conditions apply
"Definitely. I believe Agenda for Change should be implemented for practice nurses pay." - Name and address supplied
"GPs must be laughing their socks off. Nurses...gullible fools." - Name and address supplied
"No. I have not been rewarded within the past four years, one pay rise of 80p an hour, making my pay £11.30 an hour - Name and address supplied
"Definitely. I do not believe GPs will adopt AfC" - Name and address supplied
"I do not agree that practice nurses should be given extra pay in the belief that they are doing extra nursing work. Nurses in other specialties are carrying out tasks originally performed by junior doctors and are not getting recognised for it. Paying others more would be unjust; it should all depend on an individual's banding" - Name and address supplied
"I think nurses should have the extra pay for the amount of work that we do" - Name and address supplied
"What is really needed is a pay structure that is national and reflects the progress/extension of practice nursing roles and contribution in general practice. The Whitley Scale was withdrawn and effectively stopped progressive increments that reward nurses for development in skills and services to patients, as seen in other NHS settings, eg, community and hospital nursing" - Name and address supplied
"Definitely" - Name and address supplied
"Yes. I have been rewarded for the last two years with a one-off payment from my employers" - Name and address supplied
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