Business Guide for GPs in Scotland – Funding and Contracts

In addition, the Scottish Government has withdrawn national funding for transition services payments, intended to compensate practices that remain required to provide services that were to be transferred to Boards under the GMS contract, and has suspended funding for the Sustainability Loan Scheme, a major part of the 2018 GMS year. contract

The main thing that has prevented individual GPs’ incomes from falling more severely is the decline in GP equivalent total hours of work in recent years, which effectively means that practice profits are shared among fewer WTE GPs than was previously the case. This trend should be of grave concern to the Scottish Government given the negative impact it will have on visit volumes and patient access. This situation can only be changed with increased investment in general practice. Unless and until this happens, matching staff numbers and partner meetings with available funding will remain the primary option that practices must protect their own profitability.

This should not mean a further increase in individual workload, but rather the number of visits the practice can offer, in line with the BMA’s safe workload guidelines.

Failure to maintain the relative value of partners’ income undervalues ​​the important work that GPs do and will ultimately make it more difficult for the practice to recruit new GPs and sustain itself. In times of underinvestment in general practice, GP partners are not required to independently fund the shortfall between what the Scottish Government and NHS boards provide to the practice and what is required to provide the level of service that patients need.

In practices where partners have seen GP income decline in real terms year on year, GP partners have sacrificed their own income to maintain levels of patient care in the face of ever-increasing demand. Many GPs are working harder than ever for less personal income, reducing pressure on the Scottish Government to adequately fund general practice.

GP practices providing NHS contracts are significantly more limited than other types of businesses in their ability to gain additional business and therefore increase revenue. Therefore, the primary option by which practices can protect their profits in the event of funding cuts is through proportionate cost reductions. This is, of course, difficult to achieve beyond certain natural capabilities, given that the main costs of practices come from hired staff and partner income, but options for achieving this goal are discussed later in the document.

The BMA recommends setting an annual target for an appropriate level of income for each therapist partner session and regularly reviewing business decisions against this target. Practitioners must determine what level of earnings is appropriate for them, but some suggested points of comparison are discussed below.