GP practices have lost income from a broad range of activities because of changes triggered by the pandemic - with some losing tens of thousands of pounds from a single area of work, and others facing a significant overall loss because several smaller income streams have disappeared.
Practices that rent out rooms in their premises to other services such as physios saw this income evaporate during lockdown. Practices that rely on income from medical student placements have lost out, as have GPs providing services such as minor surgery - and funding from contracts for work such as spirometry has stopped.
Meanwhile, practices are now facing increased costs for locum GP cover - and to cover wider staff absences - as COVID-19 cases force NHS staff to self-isolate at a time when GP workload has surged.
GP income lost
Specialist medical accountant Andy Pow, of Mazars UK, told GPonline: 'We’re seeing a few practices with probably in excess of a £50,000 loss of income in the short term. Their costs are not changing - so if you lose £10,000 it does mean losing £10,000 from partners' income.'
Most practices were likely to be facing some financial loss due to the pandemic, Mr Pow warned - although across a broad spectrum with those at the top losing tens of thousands of pounds.
He added that even relatively small practices could be losing significant sums that could equate to the funding required to employ a practice nurse or part-time GP.
'It's not a drop in the ocean - if it’s a five-handed GP practice, £50,000 is a sizeable drop in income,' Mr Pow said.
He said relatively small practices that deliver medical student teaching could face a loss of around £20,000 from the cancellation of placements, while a practice offering minor surgery might earn more than £20,000 - particularly if they are contracted to provide the service to patients across their area rather than only for their own registered list.
Practices also face losses from locally-commissioned enhanced services - sometimes bundled together into a 'basket' of services. CCGs in some areas are understood to have offered income protection, but not to the full value of the potential income lost.
Mr Pow warned that practices could still struggle with the administrative workload required to deliver stripped-back QOF requirements for 2020/21 amid ongoing pressure during the pandemic.
He backed calls from the RCGP and BMA for a reduction in bureaucracy - questioning whether processes such as appraisal or CQC inspections should have restarted during the pandemic. 'Is there any great benefit from appraisal at the moment, or CQC? Practices don't need another tier of admin - organisations need to be a bit more pragmatic this year.
He also warned that he didn't know a single practice capable of using its full share of funding for recruitment of staff through the additional roles reimbursement scheme (ARRS) this year - and urged officials to consider redirecting the cash to support practices facing a loss of income.
GPonline reported last month that four in five GPs say workload is now running at a level that is above normal for the time of year - with rising demand for consultations, the strain of remote patient contacts, staff absences and the backlog of NHS treatment adding to pressure as a COVID-19 second wave builds in the UK.