General Practice Finances
The government requires financial transparency from practices as recipients of NHS money. Rather than present the minimal figures required we thought it would be interesting to put some figures in context.
Nationally, General Practice receives 8.4% of the money spent on the NHS. For every £10 spent GP services receive £0.84 and with this, general practices deliver 90% of the patient care in the NHS.
General practices are mostly small, independent businesses which operate as contractors to the NHS. The Wall House Surgery is one of these, a partnership of five partners who run the surgery and employ the other staff, receptionists, doctors, nurses and administrative staff who work here.
The surgery holds a ‘General Medical Services’ contract with the NHS which enables us to look after our list of nearly 16,000 patients. Our total NHS income under this contract last year was £697,762. Two thirds of this is paid as a capitation, in proportion to our list size, and the rest is contingent on achieving certain clinical and administrative targets. About 70% of this income is spent on the costs of running the practice, primarily paying the employed staff.
We pay above the Living Wage to all our employees. Partners’ drawings are taken when all the expenses of the practice have been met and so vary from month to month.
Very roughly, the surgery provides 65,000 consultations per year with doctors (both face-to-face and by telephone) and just under 30,000 appointments with nurses, giving a cost to the NHS of approximately £25 per consultation. In comparison, a single outpatient appointment in hospital costs the NHS between £80 and £180.
All GP practices are required to declare the mean earnings (e.g. average pay) for GPs working to deliver NHS services to patients at each practice.
The average pay for GPs working in The Wall House Surgery in the last financial year was £77,000 (full time, pro rata for part time) before tax (at 40/50%) and national insurance. This is for 3 full time GPs and 7 part time GPs.
Our GPs currently begin work between 07:30 and 08:00 to do paperwork before surgery starts. They tend not to have a lunch break as this is when they carry out home visits and do admin such as signing prescriptions, responding to patient messages, dictating referrals and attending practice meetings.
After evening surgery finishes, GPs most often work until 19:00 or 20:00 again to do their paperwork, prescriptions, urgent requests, results and deal with hospital letters received. More often than not, GPs will work at some point over the weekend to try to keep on top of the mountain of admin work. This means that GPs normally work approximately 60 hours a week and in real terms are paid on average £25 per hour.
Over the past 8 years practice income has remained static, while expenses have, of course, risen. This has meant that while spending on the NHS as a whole has risen, the proportion of that money coming to general practice has dropped significantly and continues to fall. A political campaign is underway to try to reverse this trend.
We certainly feel that earning £25 per hour is not being overpaid for the job GPs do, despite the media and politicians spin. We have tried hard over recent years to maintain or improve the level of care we provide, but as it becomes increasingly difficult to do this the ongoing support of our patients is vital, and very much appreciated.