The average incomes of GPs working in single hander practices are slightly more than 8 per cent higher than those of their counterparts working in large practices, figures show.

  • Income of single hander GPs continues to be greater than counterparts at larger practices, despite recent fall.
  • Increasingly difficult for single hander practices to ‘work in isolation’, says NAPC chair
  • Source says GP funding levers could be used as incentives in large practices

The average gross earnings of single hander GPs – practices with only one partner – was £107,200 in 2013-14, compared with £99,100 for those working in practices with six or more GPs.

The finding, which repeats previous years, comes as national policymakers and NHS leaders are urging GPs to move to bigger practices, networks and other provider forms.

A report on income and earnings was published earlier this month by the Health and Social Care Information Centre. It said the gap between small and larger practices had narrowed in recent years.

National Association of Primary Care chair Nav Chana, a GP in Mitcham, south London, said it would become increasingly difficult for smaller practices to remain in their current form given the improvement in access and outcomes required.

Dr Chana said: “As we develop a primary care system based around improving access and improving population health outcomes – and all the expectations of society – it’s going to be increasingly difficult for small providers to work in isolation. It behoves a more networked arrangement of primary care.”

The figures, produced by the HSCIC based on a sample of anonymised tax data, includes GP income from both NHS and private sources.

One source involved in national discussions about GP services reform suggested using existing GP contract payments, such as the quality and outcomes framework and enhanced service payments, to motivate larger practices and working together. The source said: “One way of incentivising GPs to scale up could involve using existing contractual means.

“Using the alternative primary medical services [APMS] model to facilitate system integration by setting this [integration] as a unique performance indicator is a realistic possibility.

“A move from some of the current enhanced services to ones that develop incentives, bringing practices and other providers together, is a further lever.”

British Medical Association GP committee chair Chaand Nagpaul cautioned against a simple comparison between GPs in different sized practices.

Dr Nagpaul said: “These figures are not adjusted for workload, so it’s not like hospital staff working in the same place alongside one another.

“For instance, many single handers have a larger workload than some of their counterparts working in larger practices. These figures show a need for a measurement of GP workload. General practice has been disadvantaged because of its capitation based funding [as opposed to activity based].”

The HSCIC’s data also showed that the average taxable income of GPs across the UK decreased by almost 3 per cent in 2013-14, compared with the previous year.

The average income for both contractor and salaried GPs in 2013-14 was £90,200, compared to £92,900 in 2012-13.

Salaried GPs saw their income fall 3.3 per cent from £56,400 to £54,600 in the same period.

NHS Alliance chair Mike Dixon described the reductions as “disgraceful”.