GPs are self employed contractors of services to the NHS. Our practices are businesses but set within a framework of extreme complexity and are not free to operate as independent businesses; a rather peculiar situation but one which has benefitted the NHS, patients and GPs alike, but with certain downsides too.
GP earnings are extremely complex, made up from a price per registered patient (basically around £88 per patient per year – not a lot for comprehensive medical care!) with complex ‘weightings’ for different areas, different ages of patient with additional payments for reaching certain national or local targets, participating in certain health promotion schemes such as smoking cessation and fees for some individual items of service such as vaccinations.
We have our premises rental and some other associated costs reimbursed but have to pay all our staff costs including NI and employer’s pension contributions and of course the considerable expense of equipping and running the surgery (£100,000 of partners’ money for the new surgery). Accounting for all the money from the many different sources is tricky and very time consuming – nothing is at all straightforward. And much of it arrives very late and sometimes incorrect from the different sources and has to be chased.
Predicting our income for the next year is very hard as there are so many variable and also changes. This makes planning our service and recruiting staff difficult.
Our pay is set each year following a convoluted series of negotiations based between our negotiating committee and the government on the recommendations of the Doctors’ and Dentists’ Pay Review Body, an independent committee which reviews expenses, manpower issues, demand and workload, new ways of working, government targets and so on.
Determining what a GP earns is also very difficult as there are so many factors to take account of – you may have seen figures bandied around in the press but often these are gross, before practice expenses are taken out and may well also include private services earned outside the NHS.
Our regulations now require all GP practices to publish the following statement:
“NHS England require that the net earnings of Doctors engaged in the Practice is published, and the required disclosure is shown below. However it should be noted that the prescribed method for calculating earnings is potentially misleading because it takes no account of how much time Doctors spend working in the Practice, and should not be used to form any judgment about GP earnings, nor to make any comparison with any other Practice. 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 Willow Tree Medical Doctors in the last financial year (2022/3) was £73,390 before tax and national insurance deductions. This relates to 9 part-time GPs who worked in the Practice for more than 6 months and 2 locums working for more than 6 months during this time”.