Business guidance for GPs in Scotland – Financing and contracts

In addition, the Scottish Government has withdrawn national funding for temporary service payments, intended to compensate practices for continuing to provide services that should have been transferred to boards under the GMS contract, and has withdrawn funding for the scheme for sustainability loans, a core part of the 2018 GMS, have been discontinued. contract.

The main thing that has prevented individual GPs’ incomes from being eroded more seriously is the decline in recent years in the number of full-time equivalent GPs, which in effect means that practice profits are shared between fewer WTE GPs than was previously the case. That is a trend that should be of serious concern to the Scottish Government given the negative impact it will have on appointment numbers and access to patients. This will only be reversed if more is invested in general medicine. Unless and until that happens, aligning staff numbers and partner sessions with available funding remains the most important option practices must have to protect their own profitability.

This should not mean that individual workloads increase further, but rather that the number of appointments a practice can offer remains in line with the BMA guidelines for safe workloads.

Failure to maintain the relative value of partner revenue will underestimate the vital work that GPs do and ultimately make it more difficult for practices to recruit new GPs and sustain themselves. During periods of underinvestment in general practice, it is not the responsibility of GP partners to self-fund the gap between what the Scottish Government and NHS Boards provide to the practice and what is required to deliver the level of service that patients need.

In practices where partners have seen an erosion of GP revenues in real terms year on year, GP partners have sacrificed their own revenues to maintain service levels for patients, despite ever-increasing demand. Many GPs are working harder than ever for a lower personal income, reducing pressure on the Scottish Government to adequately fund general practice.

GP practices offering NHS contracts are significantly more limited than other types of businesses in their ability to acquire additional clients and thereby increase turnover. Therefore, the main option practices have to protect their profits when funding is eroded is to proportionately reduce spending. This is obviously a challenge for practices to do this outside of certain natural opportunities that arise, as practices’ main expenses relate to staff and partner revenue, but options for achieving this are discussed later in the document.

The BMA advises that practices should set an annual target for an appropriate level of income per GP partner session and regularly review business decisions to assess whether this target is being achieved. It is up to practitioners to determine what income level is appropriate for them, but some suggested comparison points are discussed below.