Publishing GP earnings is more complex than ministers think
If GPs have to publish their earnings, Bob Senior asks, how will those figures becalculated? Will they be accurate? And what purpose will it serve?
In the new contract announced last month, GPs have been asked to publish the average earnings of all partners and salaried doctors working at the practice by April 2016 on their website.
The net per-practice figure that is published will need to include earnings from NHS England, CCGs and local authorities for the provision of GP services that relate to the contract and which would have previously been commissioned by PCTs.
Expenses involved in providing the core services, including employers’ pension contributions, will be deducted from the core income to arrive at an ‘earnings’ figure.
However, costs relating to premises will not be included. Although the contract does not spell it out, I imagine that all notional rent, cost rent, loan interest paid and rent paid are likely to be removed from the calculations. Non-core income (private income, student fees, out-of-hours income) should not be included either.
The 2015/16 contract guidance also introduces fresh complications. Practices must report the mean net earnings of GPs in the practice for 2014/15, including contractors, salaried GPs and any locums working in the practice for longer than six months. The implication is that core contract profits have locum costs and salaried GP costs added back, with the end result then being divided by the number of partners, salaried GPs and long-term locums.
The result is likely to be a meaningless figure, produced after considerable aggravation and additional cost, none of which GPs need.
Even if comparable results can be produced, patients are unlikely to be up in arms. Certainly, some GPs in low-earning practices may discover what can be earned elsewhere and be encouraged by the figures to apply for jobs out of the area.
And it may get worse. NHS England has revealed that GPs will be expected to publish individual net earnings from 2016/17. In my opinion, the whole concept should follow the path of many great Government ideas and be quietly shelved.
Bob Senior is chair of the Association of Independent Specialist Medical Accountants and head of medical services at Baker Tilly