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Gold, incentives and meh

Average GP practice receives £136 per patient annually - less than a Sky TV subscription

The total funding given to each individual practice has been published for the first time by the Government today, revealing that the average practice received funding worth £136 per registered patient in 2013/14.

But this amount conceals massive variation between practices and illustrates that annual funding for unlimited access to GP practices is less than an annual Sky TV subscription, which costs £238 per year.

The Health and Social Care Information Centre today revealed that 13% of the total funding came from QOF, while 8% came from premises payments and 8% came from enhanced services.

The publishing of individual practice funding was included in the 2014/15 contract at the behest of the Government in order to improve transparency.

The GPC, which has reluctantly agreed to the publication, has warned it will not be useful or informative to patients. Opponents have also argued that it is a breach of GPs’ privacy.

Proponents of the publication, agreed in principle under the 2014/15 GMS contract, have argued that publishing individual pay would be helpful for GPs to prove a decline in net income after pension contributions and medical indemnity cover.

Practices will be required to publish these figures on their website by April 2016 under the new GP contract deal.

But NHS England said that this was an ‘interim solution’ before NHS England pushes ahead with ‘publishing individual GP net earnings in 2016/17’.

The first publication of these figures revealed that APMS practices received £192.85 per patient, compared with £140.52 for PMS practices and £131.45 for GMS practices.

One APMS practice - the Accrington Victoria Health Access Centre in Lancashire - received £2,002 per patient.

It also shows huge variation between different areas, with practices in Greater Manchester receiving £110.60 per average weighted patient, compared with £166.05 in East Anglia.

However, according to the figures, some practices received as little as £25 over the year, calling into question the usefullness of the figures.

Dr Chaand Nagpaul, chair of the GPC, said: ‘These figures demonstrate that GP services are delivering comprehensive care for a whole year at a cost of £136 per person. This funds unlimited access to GP appointments - now more than 6 visits per year on average - as well as home visits and care for housebound vulnerable patients, immunisation programmes, cervical screening, chronic disease management and many other services.

‘However, GP services are finding it increasingly difficult to make this funding stretch to meet the demands that are now being placed on them. Many GP practices are struggling to cope with the growing needs of their aging populations on shrinking resources that is made worse by staff shortages and the wider transfer of more unresourced work from hospitals into the community.  Politicians and NHS managers now need to focus their energy on ensuring overstretched and underfunded GP services get the resources they need to deliver enough appointments and services to their patients.’

On the regional differences, Dr Richard West, chair of the Dispensing Doctors’ Association, said: ‘It’s important to understand that the variation in weighted payments between urban and rural areas is because many rural practices are also receiving reimbursement for the costs of the drugs they are permitted to dispense to their patients. It is not because rural practices receive better funding to provide primary medical services.’

What £136 a year can’t get you

- A Sky subscription on the Original (cheapest) bundle: £17.20 per month = £206.40 per year.

- The rise in the price of a train season ticket from Guildford to London (not the ticket - just the rise in the cost of the ticket) = £144 this year.

- A 4G phone subscription with a free phone: cheapest one available with a free phone is £12.50 per month = £150 per year.

- A 51g Mars bar every day: 60p x 365 days = £219 per year.

- A subscription to the Observer every week = £150.80 per year.

An average bottle of wine every two weeks = £208.52 per year.

A trip to the cinema every fortnight = £169.78 per year.

A haircut every month = £179.40 per year. 

Read here how much each practice gets funded


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Readers' comments (57)

  • Just got a quote from PetPlan for a years health insurance for a rabbit; £175.80. No cover for the first 14 days and £65 excess per new illness.

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  • Don't panic if your practice is somewhat less than £136 per patient, the figure includes dispensing practice income so if you are not a dispensing practice the average is quite a bit lower than £136 per patient. For dispensing practices the average will be quite a lot higher.

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  • vet insurance for my 2 dogs is £2160p.a, plus excess £50 and 15% per condition per annum.

    £136 per human per year is so cheap its criminal. Why do GPs undervalue themselves so chronically?

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  • This is depressing !!!

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  • 37. 5 p per day - if you have to ring the patient on their mobile to give results / discuss illness / triage appointment then kiss goodbye to a week of income

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  • My dog aged 14 costs me £400 per year, £75 excess, co-payments of 20% of any claim...

    we had JUST ONE patient make 140 consultations last year, so we got paid 97 pence for each one !!

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  • No bias in this headline!

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  • Non Obamacare health insurance average, on metasearch engine for 60 year old living in Brooklyn NY, $6,200 per year per person, but with 40% co-payment and many health services not covered

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  • 37.5 p per day = 1 mobile telephone triage . However efficiency savings can be made with two bean cans and piece of string .

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  • Anonymous | NHS Manager | 12 February 2015 11:21am

    What bias do you see? headline seems true to me. tinted eyes maybe?

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  • I'd rather have sky. All those top medical programmes you can watch on it will give you enough advice plus you can watch the footie if you pay more.

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  • Already suspicious that it contains many errors. Can't be bothered checking our data. But I notice that a neighbouring practice that is renowned for its fantastic patient participation group earned no income from the PPG DES. Not credible.

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  • BUPA GP....15minutes £70, 30 minutes £128. Average 6 visits per year per patient.

    10mins x 6 = £280/patient/year.

    We are the medical equivalent of "pound shops".

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  • They have included dispensing payments for drugs but not costs!! Do they think we get them for nothing!! Vastly inflates spending per head for dispensing practices and the overall figure so these figures produced by the numerically illiterate and endorsed by the GPC Dr Nagpaul look at yourself in the mirror this is a resignation issue

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  • If a full time GP is working 9 sessions a week and in each session sees patients for 3hrs, then he will be seeing 162 patients a week (27hrs x 6pt = 162 patients).

    The same GP will be seeing 8424 patients a year ( 162 pt x 52 weeks = 8424 patients or consultations).

    If the same GP is earning £85,000 per annum, this will roughly equate to the GP getting paid £10 per consultation)

    So a full time GP is paid £10 per consultation but in addition the GP is expected to do all the relevant paperwork, home visits for this patient, admin work, management work, etc for that £10 consultation.

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  • as above and that 10 pounds consultation can lead to complain as well to ruin the life of hard working doctor.

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  • Una Coales. Retired NHS GP.

    Now you get why you are being worked to death as how may scarce NHS GPs provide 7/7 care to 64 million Brits (10 million elderly) and visitors from 27 EU nations on £136/patient/year?

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  • Vinci Ho

    For those who are still searching an explanation why there is a GP recruitment crisis or even denying there is a crisis(what's your name, son?), open your eyes wide to look at these figures........

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  • Diane Ridgway

    "One APMS practice - the Accrington Victoria Health Access Centre in Lancashire - received £2,002 per patient"
    Actually - no the practice didn't.
    AVH is an 8-8/365 walk in clinic with a registered list - of 1,025 patients - AVH has a non-registered walk in list and last year the centre saw in excess of 45,000 patients over and above the registered list, with its dedicated GP's and fantastic nursing and admin team often staying until 10pm to see the patients waiting.
    So that's £49.99 per patient.
    And the DH wonder why hard working GP's are leaving the profession in their droves - and no-one wants to work in general practice?
    With stupid articles like this causing havoc with patients perception and in the media its not rocket science is it?

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  • And how can GPs provide a modern safe service at this Poundland rate of pay?

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  • Our data is wrong. I haven't looked at actual amounts but we claim neither extended hours nor "facilitating timely diagnosis....dementia" yet it states we are paid for both.

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  • Just registered my puppy at the vet.
    Routine care ( worming treatment and jabs) £20 per month ie £240 a year.
    Any actual consultations or illness extra.

    Insurance £600 per year with £100 excess.

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  • i see all the comments about pet insurance - i see the comments about they have miscalculated dispensing practices - i actually ignored the APMS practices when looking at the list - i know they offer "different" care.

    What no one has explained or commented on here - is why does my practice get roughly £115 per pt and there's a lot of practices getting £200 £300 or more per pt. I seriously doubt they are giving a better service or better access or better care.

    sounds to me like they are either having an easy life- or make a hell of a lot more money than i do.

    lets have a debate about equalising it - not pet insurance.

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  • 3.36 the one with higher values per patient are dispensing,this is not about profit this is about turnover.

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  • My local curry house does an all you can eat buffet on Sundays for £12.95 thats £673.40 a year if you go every Sunday. And we do all you can eat medicine for £136- want a naan with that- we're all naanas!

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  • For me - the real question is why isnt this the lead story on the BBC news - you can bet if it showed we made £1000 per pt each it would be- no the story - GPs are good value and on average get paid less than £10 per pt seen isnt newsworthy? why arent our leaders pushing the media? hold a news conference

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  • @3:42pm
    dont be so patronising - i can read a spreadsheet. they arent all dispensing by any means. there are plenty of practices GMS.PMS non dispensing with double or more the income we get - keep explaining that?

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  • Interesting; the Practice next door in the same building and a similar size gets 33% more per patient. They are PMS we are GMS. Just wait for co-commissioning to fragment the National contract. Every man for themselves and will the last GP to leave please put out the lights.

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  • I haven't see my GP for 7 years - so roughly £1000 over the period for nothing!! The report is not helpful, should be based on Consultation nos NOT no of Patients

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  • 5.41pm you obviously don't understand what average means.

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  • BUT £136 includes wages of staff, running costs etc.
    PROFIT per PATIENT in NI is £ 60 ie if you had 2000 patients you get £ 120000.
    Average Consultation is 6.4. % paper work is 40%.
    So, 60 divided by 6 = £10. Factor in 40% paperwork and you get £ 6 per consult.
    Work it the other way if you wish.
    £6x 40 consultations per day = £ 240.
    Add 40% for paperwork [£160]= £400 per day.
    400 x 20 days/month =8000 x 12 months = £ 96000.
    So, profit per consult is £6.
    Take home pay per consult is £3.00

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  • So disingenuous!

    Notice how it is impossible to directly compare APMS practices. Because this would show embarrassingly high £ / patient.

    Notice how the average £ / patient, admittedly low, is a GROSS payment. This is based on Total Payments, not Total Payments minus discount. That means that out of the quoted £ / patient GPs have to pay for their premises and staff, and their OOH deduction, LMC levies, and pension contributions. Then they have to pay other business expenses, e.g. professional indemnity, and finally their employee superann and income tax.

    Not much left after that lot, perhaps £20-30 per patient? Hence the computation of around £4 (net) per consultation

    But even if we take the £136 as the GROSS 'Client pays' figure, its remarkable what is offered for £2.60 per patient per week!

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  • Una Coales. Retired NHS GP.

    You'd better have a look at the HSIC spreadsheet of 8000 surgeries (Pulse link how much each practice gets funded). I couldn't open on my ipad but it opened on my android. Some were given only £15/pt/year to fail and close their doors while another was given £1700/pt/year for 2,900 patients to receive £4 million after expenses! Seeing is believing!

    Not all surgeries are equal...

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  • So it comes to this...the largest figure it is possible to create in terms of funding per patient. Not a lot of press coverage despite these figures clearly being ripe for propaganda purposes and completely misleading.

    Where is the column for the funding to actually do what the population think we are paid for?... Not the extras of which the population are oblivious. Those are..... Extra!
    Shall we call it funding per patient to visit as many times as they like/year?... It will be a lot less than £135.

    This + CQC risk ratings + PHE oops we forgot to tell you all the flu jab is doing nothing for your patients this year = feeling of being ruled by innumerate fools.


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  • congrats to whoever is responsible for negotiating the contract !

    there is no way this will make mainstream news as the public are not prepared to believe it that GPs get £136 (on average) a year to look after them.

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  • the simple fact is the public do not understand that the nhs works as a giant ponzi insurance scheme - fine when there are few pulling money out but heading towards collapse when everyone wants a piece of the pie ... and an awful lot of people want a piece.

    reading the comments in the popular 'press' leads to a conclusion that the public don't have a clue. there are many who will feel that £136 is poor value as they either don't use the service (i.e. young and healthy) or when they want to use the service they can't get access (i.e. waiting days/weeks/months to see their gp). those members of the public who we see weekly (i.e. 52 times in a year for £136) still moan as they can't get there boob job / fertility treatment or whatever when they want it.

    it will be better for everyone to push the debate about funding the nhs back to the public - do they want to opt out of funding the nhs and take care of their own health costs or are they going to properly fund the nhs so they can get the service they want? but i'm not going to subsidise the nhs by further cutting my pay - i'm already seeing 60 patients a day under greater paperwork and higher risk. It is time the true cost of healthcare is passed on either to the state or to the individual.

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  • i'm sorry but i think doctors in general are vastly underpaid compared to other professions.

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  • Call to GPC - get this in the national press. Now.

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  • I totally agree that GP are underpaid however I would like to point out that I haven't seen my GP for about 5 years therefore based on these figures he's received £680 for doing absolutely nothing!
    This is essentially the same argument that some of you are making when comparing the amount the private sector received for actually seeing a patient. They don't get anything for not seeing a patient therefore that needs to be factored in to the calculation.
    Forgive me if I've missed it but surely the only truly comparable measure would be to break down the total funding by consultation so that apples are being compared with apples?

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  • @NHS manager 8.25
    I am afraid you have missed the point! You sound like a very reasonable person but unfortunately you don't seem to understand.
    This funding is to cover all the patients on the list, some of which never come to see us, others are in almost every day. Just as those who do not come in need to be taken into account, so do those who come in all the time.
    The figure if 6 consultations per year us an AVERAGE and therefore does take both of these into account.
    For some people we are doing 100-200 consults a year for £136. Ie less than £1 per consult.

    A payment per consult would be an option, in which case some patients would cost an enormous amount and others would cost nothing.

    However, the current system is based on a flat payment per year for an AVERAGE number if consults. Incupidentally, the average number if consults per year has doubled in the last 5 years with no increase in the flat fee. How many organisations could double their activity for the same income?

    We have reached the end if the road. There is no more to give.

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  • It is average profit per patient year that matters. In 2005 , we GPs in NI made on AVERAGE £80 for 4 consults ie £20 per consult.
    Today we make AVERAGE £60 for 6 consults ie £10 per consult. This is a 50% pay cut in spite of QOF, DES,LES etc.
    No wonder everyone wants to leave. Would you work anywhere where your salary gets halved in 10 years per item ?
    Besides, there is a shortage of GPs.
    2 Legal firms next door to me made over £2 million on legal aid last year.
    We GPs are being taken to the cleaners and the result is that you simply won't have them.
    The fault lies squarely with the GPC, who are very good at wringing their hands and doing nothing.
    Don't worry, soon you will have no GPs to kick.

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  • There are big differences in Global Sum per patient for neighbouring practices. That's beyond ridiculous, it is obscene and unjust. It shows not only how wrong it was to apply the Carr-Hill formula, but how blitheringly incompetent the GPC was to agree to it.

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  • Funding and staffing disparities are endemic in the NHS. Kings has 125 consultants to 100 beds, a failing hospital in Nottingham has 52. The fact that it only fails because of such disparity no one seems to see.
    They spend £540 per patient in London and £186 in Lancashire. Some GPs make £120 profit per patient year compared to £ 36 for others.
    Sheer madness.
    They cut 300 staff in Mid Staffs and it fell from a 3* to oblivion.
    So, replace the staff. Oh no, enter Francis and 300 recommendations, not staff.
    It is the fault of the BMA. We ahve to get like lorry drivers and pilots - define normal work and normal pay.
    Until we do, we will always have this = extreme workloads, but never enough for patients, papers or politicians.

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  • Time for fee per item contract ala secondary care.As a commenter on these pages has said numerous times "If you pay them they will come".If they carry on in this archaic way"we're all doomed"We need an honest debat on the funding of the NHS before its too late and there is nothing to salvage.Shame our superiors and governors are to spinless/stupid to address the problems.History will judge them.

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  • We do not earn £136 per patient. That includes staff and practice nurse pay, heating, lighting , running costs.
    You might as well David cameron earns 12 million because that is what it costs to run Downing street.
    No. We get £73 in England and £ 60 in NI per patient.

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  • Lots of people missing the AVERAGE idea and Gross / net pay per patients.
    One major factor missed also is the fact I haven't needed the fire brigade, police (directly) or ambulance service but my taxes are being used to have that service for when it is needed. I want a fireman ready and police guarding my house- it ain't going to happen but there is a service ready to respond to my need. I bet they'd say the same thing about payment per call being too low.
    My kids do not trouble the local authorities coffers for schooling either BUT we live in a country with public education health and security services that make all our lives better and I do not begrudge paying my fair share to have those services for all. Public service is valuable beyond payment but when it is allowed to decay to the extent a drs value (take home) is 3 quid for a professional opinion we'll give up. If the government wants us to eat more sh!t they need to make it taste better with more bread or decrease the filling!

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  • NHS Manager | 13 February 2015 8:25am

    'I totally agree that GP are underpaid however I would like to point out that I haven't seen my GP for about 5 years therefore based on these figures he's received £680 for doing absolutely nothing! '

    don't blame yourself for falling for the same false assumption that a lot of the public believe i.e. paying for nothing. You have been paying for 'health insurance' and risk i.e. you might be ok today , right now but tomorrow you could have a serious illness which may cost many thousands than the £600 or so quid you have paid. The NHS works by pooling money and hoping that not everyone needs care. If you think of car insurance - i've paid insurance for 20 years without a claim - is that money wasted ? It's to cover IF i have to claim.

    I've got no problem if you want to withdraw from the NHS and save and invest your £600 but if you fall ill then you should cover your own costs of healthcare.

    that's the problem the public want their cake but want someone else to pay for it.

    now do you understand how it works ?

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  • the other issue that bothers joe public is access

    if you want timely access for a plumber, accountant, lawyer, mechanic etc. you have to book in advance - it is very rare to get same day access AND they will charge for work undertaken by time and activity.

    if it is an emergency call expect to PAY unless you have a cover plan - usually plans are not unlimited.

    we can argue all day if the average is £7.50 or £200 per patient but no professional service provides UNLIMITED UNCAPPED access for that amount. most will have 'fair use' or throw in extra charges.

    i can not be in two places at once so i'm either seeing patients in surgery, visits, or doing paperwork - everyone wants a slice of my time. I can not do any more safely. so if the public wants better access then either reduce demand or increase supply both are going to cost.

    you can innovate until the cows come home but it isn't going to make a significant saving - the bottom line is if you get what you pay for.

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  • 'I would like to point out that I haven't seen my GP for about 5 years' This is great news but should you have the misfortune to become seriously ill you could easily find yourself seeing your GP monthly for the next 5 years - this is the principle behind insurance! It's not money for nothing, if your GP is not seeing you they will be seeing those who are currently unwell until it is your turn. £136/y (less running costs) is an absurdly low amount that is cheaper than hamster insurance

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  • Anonymous | Sessional/Locum GP | 13 February 2015 1:46pm

    £136/y (less running costs) is an absurdly low amount that is cheaper than hamster insurance

    yes ... but some dailymail / guardian reader is going to say 'we get to see the vet when we want and they are more accessible than GPs etc' ... sigh.

    the bottom line - the individual is being protected by the true cost of their lifetime healthcare cost as everybody contributes. it works when only a few need the resource. once we get to a point when there is too much demand the system will fail as it is doing now. but you do not say to the vet 'please can you cut your pay so i can pay less!'. Market forces dictate the price point. If individuals were not protected from the true cost of their lifetime healthcare then prices will rocket (eg USA). Doctors will get very rich and the same daily mail / guardian readers will now be moaning that their individual health costs are too much.

    we should let the public decide - properly fund the NHS or pay for your individual health costs but don't keep blaming the man in the middle i.e. doctors.

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