NHS Payments to General Practice - England, 2018/19

The majority of the payments are provided by NHS Digital’s GP Payments system – National Health Applications and Infrastructure (NHAIS).  These payments data were available for the first time in 2013/14; figures for earlier years are not available.

In 2015/16, figures relating to the payments made by NHS England and NHS Improvement’s Integrated Single Finance Environment (ISFE) for Local Enhanced Services (LES) – now called Local Incentive Schemes (LIS) - were included for the first time. Data capturing all ISFE ‘payables ledger’ payments has been included since 2016/17.

It is therefore important to consider the additional data included when making year-on-year comparisons, as payments made via ISFE are not available for earlier years.

For the 2018/19 reporting year, 127 practices received payments from ISFE only, and therefore did not have any practice, contract type, patient population or dispensing status information recorded in the 2018/19 NHAIS data extract. Of these, some contract types were identified from other data sources. However, contract types could not be found for 101 providers. Practices are responsible for ensuring that information on their contract type is correctly maintained and updated as necessary by their PCSE office.

The total count of registered patients recorded in this release for the 2018/19 financial year – calculated by summing the quarterly average patients at each practice where patient numbers are known - is 60,824,330, which is 0.36% higher than the published total of 59,607,191 at 1 January 2019[1]. This higher figure will include some double-counted individuals, but it is not possible to quantify the scale of this issue. This means, however, that the average payment per registered patient at CCG, region and England level should be treated with caution as there is some uncertainty around the counts of patients used in the denominator.

In 2018/19, the patient counts used to provide context in terms of practice size and in calculations of average payments per patient are the average of the quarterly counts of registered and weighted patients at each practice.

In previous reports, the patient counts were the most recently available figure and were taken at the end of quarters four, three, two or one as applicable. For more details of this methodological change, please refer to the accompanying document.

As a result of this methodological change, comparisons should not be made between the 2018/19 figures and those for previous years. However, to provide context, the England-level average payments per registered and weighted patient for 2017/18 and 2016/17 are presented in the Comparison with previous years section.

Payments are made according to and against payment codes and have been grouped into logical categories. For the 2018/19 report, three payment codes have been remapped from “Childhood vaccination and immunisation scheme” to “Non DES Item Pneumococcal Vaccine, childhood immunisation main programme”.

These payment codes accounted for the following amounts in previous reports which should be borne in mind when considering figures from earlier financial years:

• 2014/15 = £6,084,477.00
• 2015/16 = £4,768,730.64
• 2016/17 = £3,233,895.66
• 2017/18 = £6,599,208.63

See Results presented and main headings included  for descriptions of all the payment categories included in the publication.

Although the NHS England and NHS Improvement regional structure has changed since the 2018/19 financial year, practices’ NHS England and NHS Improvement regions, Local Offices and CCGs are presented as they were during the 2018/19 reporting year. This is to avoid any confusion which could be caused by reporting payments made during 2018/19 according to the current structure, where characteristics of practices differ between then and now. These could include differences in:

• practice details (such as name)
• the practice’s CCG, Local Office or NHS England and NHS Improvement region

As a result, some NHS England and NHS Improvement regions and CCGs recorded in this release no longer exist, following the restructure in April 2019.