GP Earnings and Expenses Estimates, 2021/22

Arrangements in place between April 2021 and March 2022

Arrangements to allow practices to claim for reimbursement of non-staff infrastructure or equipment changes, staff and partner costs to cover sickness absences, and staff and partner costs to cover additional Covid related work remained in effect until March 2022¹.

Funding of £10m was advanced to practices in April 2020 as an initial contribution towards this, with practices then able to draw down additional funding as required. 

A reconciliation exercise was carried out in March 2022 to recover anything from the April 2020 advance which had remained unspent by practices. While the Covid funding arrangements generally came to an end in March 2022, practices continued to be able to cover the costs of backfilling absent staff for a limited period in 2022/23.

At the onset of the pandemic, the SFE provisions around sickness locum cover were altered to allow locum reimbursement to be claimed from day one of an absence and the maximum amount claimable was doubled. This arrangement continued throughout 2021/22 and was brought to an end in January 2023 when a revised SFE was issued.

In November 2021, the BMA and Scottish Government agreed that GP Practices would receive a payment of £15m in 2021/22 with a further £15m in 2022/23 to reflect both the increased pressures caused by the Covid surge of winter 2021/22 and to reflect the ongoing requirement of GP practices to provide services that should have transferred to Health Board responsibility under the 2018 GMS contract². The second tranche of £15m was subsequently unilaterally reduced to £10m by Scottish Government in response to budgetary pressures³.

In 2021/22, practices would only have been involved in Covid vaccination in a limited number of areas. For other types of vaccine, practice vaccination income was protected with an approach to influenza and pneumococcal vaccination delivery that provided historic funding levels in exchange for a specific time commitment towards vaccinating by the practice rather than numbers vaccinated, in recognition of the difficulties Covid posed to practice delivery of vaccination⁴.

An Escalation Framework was put in place at the start of the pandemic to enable practices to respond to capacity challenges by ceasing aspects of activity such as Enhanced Services. While protection arrangements for this were locally rather than nationally agreed, practice income streams were generally maintained by health boards during periods when Enhanced Services were suspended⁵.

GP activity data published by Public Health Scotland⁶ shows that while there are month to month fluctuations in demand, activity levels in General Practice had largely returned to pre-pandemic levels by 2021/22 – albeit with a different balance between remote and in person consultations than pre-pandemic.

​​​​​​Table 2.1: GPMS contractor GPs - mean earnings, expenses and income before tax by contract type, Scotland, 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'.}

Dispensing and non-dispensing GPs

Table 2.2: GPMS dispensing GPs - mean earnings, expenses and income before tax by contract type, Scotland, 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'.}

Table 2.3: GPMS non-dispensing contractor GPs - mean earnings, expenses and income before tax by contract type, Scotland, 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 2.4: GPMS contractor GPs - median earnings, expenses and income before tax by contract type, Scotland, 2020/21 and 2021/22

Note: 

^{1. The median figures are all lower than the mean figures in Table 2.1 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 2.5: GPMS contractor GPs - breakdown of mean expenses by contract type, Scotland, 2021/22

Table 2.6: GPMS contractor GPs - breakdown of mean expenses by dispensing status, Scotland, 2021/22

Notes:

^{1.Further expenses breakdowns are published in the Excel Time Series, available under Resources on the Overview page.}

^{2. The average expenses in the ‘Other’ category for dispensing GPs are almost nine 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.}

Table 2.7: GPMS salaried GPs - mean earnings, expenses and income before tax by contract type, Scotland, 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 of salaried GPs

Table 2.8: GPMS salaried GPs - median earnings, expenses and income before tax by contract type, Scotland, 2020/21 and 2021/22

Note:

^{1. The median figures are all lower than the mean figures in Table 2.7 which indicates that there is a relatively small number of high-earning salaried GPs increasing the mean figures.}

Table 2.9: GPMS combined GPs - mean earnings, expenses and income before tax by contract type, Scotland, 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. The figures for combined GPMS GPs have shown an increase in income before tax each year since 2015/16.}

Table 2.10: GPMS combined GPs - median income before tax by contract type, Scotland, 2020/21 and 2021/22

Note:

^{1. Median income before tax estimates are all lower than the means presented in Table 2.9, indicating that a relatively small number of high-earning salaried GPs are increasing the mean figures.}