A series of amendments have followed each year – each time reducing income for the current workload, and tying existing pay to new targets (adding new QoF indicators, making them harder to meet, extending working hours). This combined with the other workload factors (increasing consultation length, increasing consultation frequency, ageing population (see Office for National Statistics) increasing medical complexity, and transfer of work from hospital means that GP workload is rising 5% year on year as GP income falls - concealed largely by the rise of "half-time GPs" working 40 hours a week which makes pay look artificially high.