GP Earnings and Expenses Estimates, 2021/22

Arrangements in place between April 2021 and March 2022

At the outset of the pandemic, elements of the GMS contract were frozen with income guaranteed. Following negotiations between NIGPC, HSCB (now SPPG) and the Department of Health (DoH), it was agreed that there would be no restart on 1 April 2021 of the contract elements that had been eased (mainly QOF and Enhanced services). The Quality & Outcomes Framework (QOF) activity and reporting continued to be suspended. Practices were asked to continue to manage their enhanced services activity in line with pressures associated with COVID-19, with due regard given to their patients’ individual clinical needs.

The level of remuneration paid to practices was based on the calculation applied in the 2020/21 financial year.

The requirement to fully engage and commit to the Covid centres continued in the 2021/22 contract year.  This amounted to almost 40 additional hours work per week which was all found from within the existing workforce.  The Department kept the position under review as they moved towards an exit strategy. Practices had to ensure that they had the appropriate infection control measures in place.

The Covid-19 vaccination programme officially commenced on 1 January 2021 (to 31 March 2022) and practices' ongoing commitment was required in the delivery of the Covid Vaccination and catch-up programme. GPs in NI played a vital role administering close to 1.4 million vaccinations in total, including over 530,000 booster doses. 

Payment was via the Northern Ireland Local Enhanced Service Covid-19 Vaccination which was updated for 2021/22. Fee levels were £12.58 per vaccine administered to all relevant patients.  Additional support money was available in recognition of the challenges of social distancing, need for staff training, data collection and possible indemnity costs.  This was based on practice populations. The total for each practice was £400 per 1,000 patients on its practice list per round of vaccinations (first and second doses).  Further additional support money was provided to recognise the challenges relating to vaccine supply and on the basis that practices used the VMS (Vaccine Management System).  This was based on practice populations.  The total for each practice was an additional £100 per 1,000 patients on its practice list per round of vaccinations.

Payment of sickness benefit from day one introduced with the Coronavirus Act continued in 2021/22.

Practices played a key role in the respective vaccination programmes during the pandemic period. This may have impacted practice income in NI during 2021/22, but possibly to a lesser extent than the previous year. The pandemic may have also impacted expenses, but again possibly to a lesser extent than the previous year.

Table 4.1: GMS contractor GPs - mean earnings, expenses and income before tax by dispensing status, Northern Ireland, 2020/21 and 2021/22

Notes:

^{1. Statistical significance relates only to the fact of a year-on-year change in income before tax. See 'Statistical significance explained'.}

^{2. Further expenses breakdowns are published in the Excel Time Series, available under Resources on the Overview page.}

^{3. Results for dispensing GPs are suppressed due to low sample numbers.}

Median gross earnings, total expenses and income before tax

Table 4.2: GMS contractor GPs - median earnings, expenses and income before tax, Northern Ireland, 2020/21 and 2021/22

Note:

^{1. The median figures are all lower than the mean figures in Table 4.1 which indicates that there is a relatively small number of contractor GPs with high earnings increasing the mean figures.}

Breakdown of expenses for contractor GPs

Table 4.3: GMS contractor GPs - breakdown of mean expenses by dispensing status, Northern Ireland, 2021/22

Notes:

^{1. Results for dispensing GPs are suppressed due to small sample sizes and so comparisons between dispensers and non-dispensers are not possible.}

^{2. Further expenses breakdowns are published in the Excel Time Series, available under Resources on the Overview page.}

Table 4.4: GMS salaried GPs - mean earnings, expenses and income before tax, Northern Ireland, 2020/21 and 2021/22

Note:

^{1.Statistical significance relates only to the fact of a year-on-year change in income before tax. See 'Statistical significance explained'.}

Median gross earnings, total expenses and income before tax

Table 4.5: GMS Salaried GPs - median earnings, expenses and income before tax, Northern Ireland, 2020/21 and 2021/22

Note:

^{1. The median figures are all lower than the mean figures in Table 4.4, indicating that a small number of salaried GPs on high earnings are increasing the mean estimates.}

Table 4.6: GMS combined GPs - mean earnings, expenses and income before tax, Northern Ireland, 2020/21 and 2021/22

Notes:

^{1.Statistical significance relates only to the fact of a year-on-year change in income before tax. See 'Statistical significance explained'.}

^{2. Perhaps because contractor GPs account for the majority of the Northern Ireland GP report population, the year-on-year changes in earnings and expenses estimates for contractor and salaried GPs combined are similar to those of contractor GPs alone.}

Table 4.7: GMS Combined GPs - median income before tax, Northern Ireland, 2020/21 and 2021/22

^Note: 

^{1. As was the case for contractor and salaried GPs separately, the median income before tax estimates are lower than the mean for both years for combined GPs in Northern Ireland.}