Exclusive: Huge gaps in GP enhanced service income revealed

GP practices now earn less than £4.50 per patient on average from local enhanced services, according to official data that reveal for the first time the huge variation in primary care funding across England.

In some CCG areas, GP practices receive no funding at all from local or national enhanced services – the two enhanced service streams offered at local commissioners’ discretion, according to GP funding data published by the Health and Social Care Information Centre (HSCIC).

But in other areas, practices earn up to £30 per patient on average – equivalent to £180,000 for a 6,000-patient practice – from these services, analysis of the data by GP reveals.

This huge gap is a key factor behind significant variation in overall income for practices. In some CCG areas, practices receive 50% more funding per weighted patient than practices in other CCGs.

In East Anglia, practices receive £166.05 per weighted patient, while their counterparts in Greater Manchester receive just £110.60.

GPC deputy chairman Dr Richard Vautrey said: ‘Even within GMS and PMS practices there are big differences in levels of funding.

‘Often this is down to history as much as anything else and the investment in enhanced services that an area has made. Some areas have invested much more.’

Dr Vautrey urged CCGs across the country to ‘look at what additional investment they can make’.

He said that variation between areas in GP funding was sometimes attributable to large numbers of PMS practices.

PMS practices receive £148.11 on average per weighted patient, compared with £130.28 for GMS practices, the data show.

But he warned: ‘It is becoming increasingly untenable for CCGs not to level up funding and not support practices that are really struggling. We need to see genuine investment.’

Expert view: Laurence Slavin

The accountant
Laurence Slavin, partner at specialist medical accountants Ramsay Brown and Partners

‘I can’t believe patients would be interested in, or frankly understand this information. It doesn’t tell you the earnings of individual doctors, just resources for the practice.

‘The main benefit could be to predatory businesses interested in targeting practices – this tells you which ones you could go after.

‘You could use this to work out which practices were worth merging with or taking over. If you were a predatory business, you could say: "We’ll go after the practices receiving over £200 per patient - not the ones on £100 per patient".

‘They could then sack some GPs and staff, provide a reduced service and keep the money coming in for as long as possible.’

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