How GPs are paid 3

My last piece talked about expenses. Since I posted it the NHS HSCIC has published an interesting document on GP income. Have a look at

This downloads (a large) spreadsheet that details gross income by GP practice. The columns split this into income sources. Now I havent explained these yet – my next piece will – but these are the different ‘pots’ in which we get paid. The main pot is our so called GMS or PMS income. The other pots include QOF a performance related income stream and a variety of little pots for doing specific pieces of work – for example dementia work, hospital admission avoidance etc. This spreadsheet adds it all up and shows what it is per registered patient for each practice. To try and be fairer it also includes a weighted patient – this is a way of adjusting the list size either up or down to take into account some patients need more care – say the elderly or the very deprived – its not perfect and huge arguments can be had over the exact formula used.

2 Notes – 1. this is Gross income – ie before all the expenses we have talked about in the previous piece – 2. The figures are slightly distorted by dispensing practices who dispense medication as the cost of that medication is in the figure and APMS practices who are often funded to operate walk in centre type surgeries so will always have a high funding per registered patient as they dont have registered patients.

So when looking at the list – ignore dispensing practices and APMS

There are several things it shows.

There is a huge variation in the income received per patient by area and by practice. This means some areas are much better funded and can spend more.

If your local GP service is poor – is it that it is underfunded compared to the rest of the country?

That on average a practice receives £136, Gross before any expenses, a year to look after you.

That General practice is effectively a ponzi scheme – the more people use it the less it can cope!

If you add up the income – the number of patients seen etc you can calculate the cost of an appointment with your GP and making some rough assumptions on expenses you can calculate a profit per patient seen.

It calculates out that the average 10 minute consultation pays a GP roughly £5 in take home pay (before tax) – Do you think that’s good or poor value?

I would suggest that people stop complaining about the service they get from GPs – and think about funding them more – but then I would say that wouldn’t I 🙂