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Independents' Day

Smaller practices receive £5 more funding per patient

Smaller practices in England receive more funding per patient on average than larger surgeries, new analysis of official figures has revealed.

Practices serving between 1,000 and 2,999 patients receive around £131 per head, while those with patient list sizes of 20,000 or more receive around £126 per head, according to Pulse’s analysis of NHS Digital data.

The difference is largely down to global sum payments, calculated by the Carr-Hill formula, which takes into account factors such as patient demographics – including age and sex – rurality, the number of new patients registered and deprivation.

GPs say smaller practices are likely to be receiving more money because they often have patients who have been at the practice for a long time. This means they are more likely to be older – which leads to an uplift in funding due to their increased use of services.

Dr Richard Vautrey, BMA GP Committee chair, said: ‘Smaller practices tend to have longstanding histories in local communities. Because of continuity of care, some may have retained a greater proportion of older patients, which would affect their funding levels.’

He added: ‘In urban areas [smaller practices] are likely to be in harder-to-recruit places, where practices continue due to the dedication of GPs.

‘But they may also be in rural areas where the demographics have not favoured larger practices, due to the population size. So both of those may change the type of patients they look after and resulting funding adjustments.’

The findings are part of a wider analysis looking at NHS Digital’s data on payments to general practice for 2018/19– which include money for QOF, extended access, local enhanced services and incentive schemes.

Pulse removed premises, dispensing fees and drugs and locum reimbursements from our analysis, as these factors skew the data – as well as contract type, due to APMS practices receiving higher payments.

The analysis also revealed a 20% difference in average funding per patient between regions – with Cheshire and Merseyside practices receiving £142 per patient, compared with £119 in the Hampshire, Isle of Wight and Thames Valley region.

This work marks the launch of Pulse Intelligence, our new service for practices in England, which allows practices to compare their funding levels with similar surgeries across the country.


Readers' comments (5)

  • thanks for the information, however if the Carr-Hill formula calculates the 'cost' of patients correctly (it is based on workload), then the increased funding is due to increased work i.e. the practices receive exactly the same as a larger practice with the same patients.
    The Deprivation measure in the formula is the 'Additional Needs Index', which is virtually identical to the IMD (index of multiple deprivation).

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  • The “Carr-Hill formula” as a centrally planned socialist/communist calculator in the redistribution of resources for state funded free for all universal healthcare fails to take into account several crucial factors (many are qualitative and cannot be simply punched into some dimwit calculator - at least while those factors are presently poorly understood) in the calculation for where resources should be redistributed to. No wonder it’s been a total disaster.

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  • @Harry
    I would agree with you that the formula does not redistribute enough money to the poorer areas where it is most needed.

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  • As a general comment it makes some sense that smaller practices have a slightly higher capitation to offset the economies of scale.

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  • makes you wonder about pulse when it puts a headline like that and shows pound notes in glorious colour!!Its the small practices that are all closing down one by one, so why make it seem like its a privilege. Highly suspicious behaviour if you ask me

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