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Smaller practices receive £5 more funding per patient, figures show


By Nicola Merrifield
3 October 2019

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Smaller practices in England receive more funding per patient on average than larger surgeries, according to new analysis of official figures.

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 publication 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 parent company’s new service for practices in England, which allows practices to compare their funding levels with similar surgeries across the country.

Reasons for disparity

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.’

Further analysis

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.

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 in-depth analysis of how GP practices within your CCG are performing compared to your peers, visit Pulse Intelligence; the new service from our sister publications Pulse and Management in Practice that provides unique and insightful financial tools to help practices make more money and operate more efficiently.

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