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NHS Payments to General Practice, England, 2016/17
- Publication Date:
- 20 Sep 2017
- Geographic Coverage:
- Date Range:
- 01 Apr 2016 to 31 Mar 2017
NHS Payments to General Practice, England 2016/17 presents NHS payments to individual providers of general practice services in England. Figures are given for the main payment categories which include Global Sum1, the Minimum Practice Income Guarantee (MPIG), Balance of PMS expenditure, Quality Outcomes Framework (QOF) and Enhanced Services.
These payments are not a record of the amount of money available for direct patient care. Instead, they constitute the majority of actual monies paid to practices by the NHS during the 2016/17 financial year. These payments are intended to cover all costs associated with the delivery of primary care medical services and include funding for premises costs, dispensing and other activities. The payments are a subset of the total invested in Primary Medical Care, as some funding - such as payments for clinical waste or some information technology services - does not reach individual GP practices but is centrally managed.
The data used for this report cover the period from 1 April 2016 to 31 March 2017 and include GP practices, and providers of general practice services, that received payments through the NHS Digital GP Payments system - National Health Applications and Infrastructure Services (NHAIS) - and NHS England's Integrated Single Finance Environment (ISFE) which captured all CCG and regional local team payments made directly to practices.
In 2016/17, all payments captured in ISFE - which amount to a net total of £806.2 million2 - are included in the report. For the 2015/16 report, only payments made by CCGs for Local Enhanced Service (LES) and captured in ISFE could be included in the published data; the 2013/14 and 2014/15 publications included data from NHAIS alone3.
The report is cash-based per provider of general practices service and presents all payments made directly to practices by the NHS, including invoices paid by NHS England and CCGs. However, any other direct payments, such as Local Authority Public Health Grants, are not included.
1. Global sum makes up the bulk of payments to practices, and allocates funding in accordance with the Carr-Hill formula. This formula takes into consideration, along with other practice characteristics, individual patients' age, gender and health conditions and calculates a "weighted" count of patients according to need. This means that two practices with the same number of patients may have very different weighted patient numbers due to widely varying patient characteristics and health conditions, and as a result, these practices which may seem to be similar in terms of list size, could receive very different levels of funding.
2. Please note that data on all payments made, by Clinical Commissioning Groups and NHS England Regional Teams, via the Integrated Single Finance Environment are not available for years prior to 2016/17, therefore comparisons between years should be made with caution.
3. Data for years prior to 2013/14 are not available.
The data (rounded to the nearest £100,000 and including ISFE payments) show the sum of NHS payments, made in 2016/17, to providers of general practice services were as follows:
- £8,883.8 million was paid across 7,763 general practice service providers, of which:
- Global Sum accounted for £3,176.8 million
- QOF accounted for £690.8 million
- Nationally the average NHS payment, including ISFE payments, was £151.37 per patient.
There are a range of factors which may affect how the figures may be interpreted which should be taken into consideration:
- Since the data are cash or invoice-based, they exclude accruals, pre-payments and other accounting adjustments made outside of the reporting year. Figures may include payments to practices that are no longer actively providing primary care medical services but received payments during 2016/17 for services in the previous financial year
- Some adjustments made during payment processing may result in what appear to be "negative payments" or "positive deductions".
- Figures may also include payments which are re-allocated to different categories after invoicing; footnotes are included in tables where such re-allocations have been identified.
- Changes to business arrangements may affect figures. For example, several practices could merge or otherwise centralise funding and payments activities at a single practice while retaining their distinct identities for all other purposes. This could be a contributory factor to apparently anomalous figures but such practices cannot currently be identified within the available data.
- Practices may provide a range of health care services, such as diabetic retinal screening, to the wider community and will therefore receive additional funding.
- Some practices are flagged as having atypical characteristics which should be taken into consideration:
- For a small number of practices, payments in the reporting year were made only via ISFE so registered and weighted patient counts could not be found as this information is taken from NHAIS. Other practices may show no registered patients for a variety of reasons such as the practice has closed or is newly opened, it has an atypical business arrangement or is a walk in centre/walk in and out of hours centre. These practices are flagged as having no registered patients and average payments per registered and weighted patient could not be calculated. However, these practices' payments are included in the CCG, regional and national averages.
- Some practices experience large changes in registered and/or weighted patient counts throughout the year which can have an impact on the calculated average payments per patient. This is because the denominator used is the last known patient count and this figure may not be representative of the count of patients throughout the rest of the year upon which payments were based. These practices are flagged as having a large increase or decrease in patient numbers.
- Some practices opened or closed during the period. These practices are flagged as having a part year of data which should be borne in mind when making comparisons with other practices.
- For more information please refer to the Data Quality Statement within the report.