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Smaller practices receive £5 more funding per patient

by Nicola Merrifield
3 October 2019

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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 our sister title 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.

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.

Longtime patients

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.

Regional variation

Our sister publication 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 article was first published by our sister publication Pulse

For more in-depth analysis on how your practice is financially performing against your peers, visits Management in Practice’s new service where you can uncover 50+ funding streams, and how to access them, read step-by-step guides all related to improving your practice and maximising profit and discover solutions to ease your staffing issues.


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