GP Earnings and Expenses Estimates 2018/19

• Between 2017/18 and 2018/19, income before tax, total expenses and consequently, gross earnings increased for both GMS and PMS GPs.  GPMS income before tax increased by around £3,900 from 2017/18.
• PMS income before tax is £4,400 higher than GMS. PMS income before tax estimates have been higher than GMS every year since 2002/03. However, except for 2015/16 to 2016/17 when the gap increased, the difference between the two has been narrowing each year since 2008/09, when the disparity was £13,000.
• The GPMS expenses to earnings ratio, which represents the proportion of gross earnings taken up by total expenses, increased by 0.9 percentage points between 2017/18 and 2018/19, from 68.3 per cent to 69.2 per cent.
• Expenses have been increasing at a faster rate than income before tax for GPMS contractor GPs in England since 2005/06, resulting in an expenses to earnings ratio which has grown each year. The 8.1 per cent increase in total expenses for GPMS contractor GPs between 2017/18 and 2018/19 follows a 6.6 per cent increase in the preceding year.

Table 1.1: GPMS contractor GPs - mean earnings and expenses by contract type, England, 2017/18 and 2018/19

Dispensing and non-dispensing GPs

• Income before tax for GPMS dispensing GPs has increased for the fifth year in succession, following decreases every year between 2005/06 and 2013/14.  However, when split by contract type only PMS GPs had an increase, with GMS GPs’ income before tax falling by 0.4 per cent between 2017/18 and 2018/19. Expenses and gross earnings increased, regardless of contract type, with PMS GPs' expenses increasing by £40,200 to put them above GMS GPs' average expenses for the first time since 2015/16.

Table 1.2: GPMS dispensing contractor GPs - mean earnings and expenses by contract type, England, 2017/18 and 2018/19

• Unlike their dispensing counterparts,  non-dispensing GPs working at practices under a PMS contract have a higher estimated average income before tax than GMS GPs. Average income before tax increased by a similar amount - between £4,000 and £5,000 - for both groups of non-dispensing GPs.
• Total expenses also increased for non-dispensing GPs, regardless of contract type. 

Table 1.3: GPMS non-dispensing contractor GPs - mean earnings and expenses by contract type, England, 2017/18 and 2018/19

Median gross earnings, total expenses and income before tax

• The median figures are all lower than the mean figures presented in Table 1.1, with the GPMS mean income before tax of £117,300 in 2018/19 being £6,100 higher than the median. The higher mean values indicate that there is a relatively small number of high-earning contractor GPs increasing the mean figures.

Table 1.4: GPMS contractor GPs - median earnings and expenses by contract type, England, 2017/18 and 2018/19

Breakdown of expenses for contractor GPs

• Total expenses for GPMS GPs in England were 8.1 per cent higher than in 2017/18, as shown in Table 1.1. 
• There were increases in all expenses categories since 2017/18, regardless of contract type, except for net capital allowances expenses for GPs working under a GMS contract, which decreased by 2.2 per cent.
• Employee expenses were the largest expenses category, accounting for more than 60 per cent of total expenses for both contract types.
• Total expenses for PMS GPs were 10.5 per cent higher than the total expenses for GMS GPs. PMS GPs have higher expenses than GMS GPs in all categories except 'Car and Travel' and ‘Other’.

Table 1.5: GPMS contractor GPs - breakdown of mean expenses by contract type, England, 2018/19

• The average expenses in the ‘Other’ category for dispensing GPs are more than four times the size of those of non-dispensing doctors. This is the largest variation in expenses categories between the two dispensing types and is to be expected as this category includes the costs for drugs. Largely because of this difference in ‘Other’ expenses, total expenses for dispensing GPs are 25.3 per cent higher than those of non-dispensing GPs.

Table 1.6: GPMS contractor GPs - breakdown of mean expenses by dispensing status, England, 2018/19

• Income before tax and gross earnings estimates increased for salaried GPs in England between 2017/18 and 2018/19, regardless of contract type.
• In contrast, total expenses decreased for all contract types. This could in part be due to a reduction in 2018/19 in the price of the Medical Defence Union (MDU) Transitional Benefits indemnity scheme, which covers a large of proportion of salaried GPs. Though this equated to a cost reduction for members of the scheme in 2018/19, the money must be repaid.
• The 4.3 per cent increase in income before tax for GMS GPs brings their average taxable income to within £1,700 of PMS GPs. This is the smallest difference between the two since the time series began in 2004/05.

Table 1.7: GPMS salaried GPs - mean earnings and expenses by contract type, England, 2017/18 and 2018/19

Median gross earnings, total expenses and income before tax

• The median figures are all lower than the mean figures in Table 1.7. For GPMS GPs, the 2018/19 mean income before tax of £60,500 is £4,200 higher than the median and the mean total expenses is more than three times the median. The higher mean values indicate that there is a relatively small number of high-earning salaried GPs increasing the mean figures.

Table 1.8: GPMS salaried GPs - median earnings and expenses by contract type, England, 2017/18 and 2018/19

• When average earnings an expenses are calculated for salaried and contractor GPs combined, all estimates have increased since 2017/18, under all contract types.
• The figures for combined GPMS GPs have shown an increase in income before tax each year since 2015/16.

Table 1.9: GPMS combined GPs - mean earnings and expenses by contract type, England, 2017/18 and 2018/19

• Median income before tax estimates for combined GPMS GPs are all lower than the mean averages, indicating that there is a small proportion of high-earning GPs increasing the mean income before tax figure.

Table 1.10: GPMS combined GPs - median income before tax by contract type, England, 2017/18 and 2018/19

This section presents earnings and expenses information by weekly working hours and gender for GPs working in England as either a contractor or salaried GP under a General Medical Services (GMS) or Personal Medical Services (PMS) contract and, as with all results in this report, covers both their NHS and private income.

Working hours bandings were derived from the contracted hours (or average weekly hours if blank) fields within wMDS. Three bandings have been used in this experimental analysis:

• Up to 22.5 hours
• 22.5 up to 37.5 hours
• 37.5 hours and more

These bandings were chosen to provide a large enough sample to be able to analyse the figures by different groups of characteristics, because it is evident that working patterns and therefore earnings and expenses vary by gender, as well as by age band. (Earnings and expenses estimates by age band and weekly working hours are available in the accompanying Excel Time Series (see Resources on the Overview page).

England is the only UK country currently collecting record-level information on working hours.

The wMDS collects details of contracted hours and average weekly hours.

• The weekly hours bands supplied to HMRC have been calculated using data from the contracted hours field.
• Where the contracted hours field was blank or contained 0, values from the average weekly hours field were used.
• Practices are advised that where a member of staff is not contracted to work a set number of hours, as is the likely case for contractor GPs, data should be entered into the average weekly hours field. However, the majority of practices enter data only in the contracted working hours field, regardless of whether the individual is a contractor or salaried GP.

Contractor and salaried GPs working for the NHS in England under GMS or PMS contracts are included in this report.

More information can be found on the wMDS data collection in the General Practice Workforce publication.

Interpreting the results

Care should be taken when interpreting the results in this chapter or the accompanying Excel Time Series (see Resources on the Overview page), particularly those that show differences in earnings according gender, age band or working hours bands. There are a variety of factors that may contribute to differences in incomes, including but not limited to the issues outlined in this section.

Contractor GPs’ earnings may be affected by the terms of any partnership agreements in effect for their practices. For example, some partners may invest in the practice premises, and such equity partners would receive taxable income as a result of this investment which could result in their having overall higher earnings than the other partners. No information is available on the age and gender profile of these equity partners, but it may be the case that younger GPs face greater pressures on their incomes and thus have less capacity for making such an investment. While females make up 44.4 percent of this report's overall estimated contractor GP population (report population) in England, this figure falls to only 25.6 per cent of contractor GPs aged 60 and over. It is therefore possible that the percentage of female equity partners is far lower than the comparable male percentage, which may partially account for the lower earnings of female contractor GPs.

It is not unreasonable that older GPs, having greater experience, receive higher earnings than their younger and less experienced colleagues. In addition, older contractor GPs may be eligible for seniority payments which are based upon a variety of factors including years of reckonable service. As female GPs are more likely to take career breaks, including absence for maternity leave, many may have fewer years’ reckonable service than male GPs of the same age, which would affect the size of any seniority payment received. Though the seniority payments scheme in England has now been phased out, it was still active during the 2018/19 financial year.

It is also possible that female GPs, both contractor and salaried, may be more likely to work fewer hours within the weekly working hours bands used in this report, which would have the effect of reducing their average income when compared to male GPs within the same band. Please refer to the GP population gender split for more details.

Known issues

Working hours

Many GPs work longer than their contracted hours and therefore the actual number of hours worked could be far higher than is suggested by the three bandings.

It could be the case that GPs who are apparently part-time according to the wMDS data also work additional hours elsewhere, for example delivering primary care in a hospital or alternative setting. Although relevant income would be recorded in the Self Assessment tax return, these GPs would appear to be part-time for the purposes of this analysis.

The weekly hours bands supplied to HMRC have been calculated using contracted hours or average weekly hours as previously outlined. However, it is possible that some GPs may work longer hours than those recorded within the wMDS.

Working hours information is a snapshot taken at 30 September 2018. A GP’s working pattern could have changed in the course of the financial year and therefore the hours worked during that quarter may not reflect the contracted or average hours worked during the rest of the financial year.

Any hours that a GP is contracted to work outside their practice will not be included in their working hours information in the wMDS. This could include private work, work in walk-in centres or secondary care settings, portfolio work, or employment as a locum at a different practice. However, their income from these sources would be included in the amounts reported in their Self Assessment tax return and so in some cases, a GP’s weekly working hours may not reflect all the work they have been paid for.

The GP population gender split

Women made up 54.5 per cent of the England report population but a far higher proportion of the part-time workforce. 

As shown in Table 1.11, within the England report population (the identifiable sample of GPs from the workforce Minimum Data Set (wMDS) who qualify for inclusion in the report, used by HMRC to match against self-assessment tax returns)., 80 per cent of salaried GPs who work fewer than 22.5 hours a week are female. In contrast, female GPs account for only 45 per cent per cent of salaried GPs who work 37.5 hours or more a week. For contractor GPs, 69 per cent of those working less than 22.5 hours are female compared to only 26 per cent of those working 37.5 hours or more.

Table 1.11: Percentage of GPs that are female, by GP type and working hours band, 2018/19

Table 1.12: Percentage of GPs that are female, by GP type and age band, 2018/19

Note: Earnings and Expenses Estimates by age band and weekly working hours are available in the accompanying Excel Time Series, available under Resources on the Overview page.

Within the two sub-divisions of the 22.5 to fewer than 37.5 analysis band in particular, it can be seen that females tend to be distributed towards the lower subdivision (22.5 to under 30 hours).  This should be considered when interpreting earnings and expenses estimates, as the greater distribution of females in the lower subdivision could have the effect of pulling down average earnings of female GPs within the wider 22.5 to under 37.5 hours band, when compared to results for male GPs.

Tables 1.13 to 1.16, which show counts of GPs from the England report population by weekly working hours band and gender, further illustrate how females are distributed towards the lower weekly working hours bands.

Table 1.13: Number of contractor GPs in report population, England, by gender, 2017/18 and 2018/19

Table 1.14: Number of contractor GPs in report population, England, by weekly hours and gender, 2017/18 and 2018/19

Table 1.15: Number of salaried GPs  in report population, England, by gender, 2017/18 and 2018/19

Table 1.16: Number of salaried GPs in report population, England, by weekly hours and gender, 2017/18 and 2018/19

• As would be expected, income before tax, total expenses and gross earnings estimates of GPMS contractor GPs in England all increased as more weekly hours were worked.
• The income before tax estimate for GPMS contractor GPs working fewer than 22.5 hours a week was 60.1 per cent of the average income before tax of GPs working 37 and a half hours or more.  The gap between the two averages has decreased by around £400 since 2017/18. 

Table 1.17: GPMS contractors GPs - mean earnings and expenses by weekly working hours, England, 2017/18 and 2018/19

• When split by gender, income before tax, total expenses and gross earnings were all higher for male GPs than female GPs, regardless of their weekly hours band.
• The percentage increase in total expenses was greater for female GPs the lower their weekly hours band. In contrast, among male GPs those working the fewest hours had the smallest increase in expenses.

Table 1.18: GPMS contractors GPs - mean earnings and expenses by weekly working hours and gender, England, 2017/18 and 2018/19

For earnings and detailed expenses breakdowns for contractor GPs in England by weekly working hours, gender and age, see the accompanying Excel Time Series (see Resources on the Overview page).

• As was the case for contractor GPs, and as would be expected, average income before tax increased for GPMS salaried GPs as their weekly working hours increased.

Table 1.19: GPMS salaried GPs - average earnings and expenses by weekly working hours, England, 2017/18 and 2018/19

• Within all three weekly hours bands, on average male salaried GPs earned more income before tax and received more in expenses than their female counterparts.
• As shown in Tables 1.7 and 1.15, there was a 3.4 per cent decreases in total expenses when looking at all salaried GPs together.  When split by weekly hours band and gender, it is apparent that the 2018/19 expenses of male salaried GPs working fewer than 22.5 hours a week and female salaried GPs working 37.5 hours or more have caused this overall reduction. The total expenses for both groups have reduced by around 31 per cent since 2017/18, although the monetary values these percentages equate to are relatively small.

Table 1.20: GPMS salaried GPs - average earnings and expenses by weekly working hours and gender, England, 2017/18 and 2018/19

For earnings and expenses estimates for salaried GPs in England by weekly working hours, gender and age, see the accompanying Excel Time Series (see Resources on the Overview page).