Proposed Dispensing Feescales for GMS Contractors, England and Wales - 2023, October release

In order to introduce new dispensing feescales from 1 October 2023 on the existing doctor-based banding basis, the following have been calculated, based on formulae determined by negotiating parties.

The figures are calculated using data for England and it is anticipated that they will also be accepted for use in Wales:

• The dispensing envelope for 2023/24 is £189.59 million. This is calculated by taking the 2022/23 envelope (£188.51 million) and adjusting this figure for any over/underspend in 2022/23 and uplifting the cost element and profit element.
• The average volume increase of fees is 2.092 per cent. This is the average annual percentage increase in volume of fees over the last 2 years. This is used to adjust for the forecast volume in dispensing fees.
• The proposed feescales to be implemented from 1 October 2023 which will deliver the envelope for 2023/24, are detailed in the ‘Proposed New Feescales’ page. The average volume increase of 2.092 per cent is applied to each existing banding to calculate new bandings in the proposed feescale.
• An adjustment factor of 0.723 is applied to each pence value at each banding to get a new value in the proposed October feescale. The adjustment factor used to calculate April feescales is 0.819, this adjustment factor is applied to each pence value at each banding for the proposed April feescales so that the new fees will deliver the remaining envelope for 2023/24.

The methodology used in calculating the feescales follows that agreed in March 2012 by the BMA General Practitioners Committee, NHS Employers, NHS England, the Department of Health and Social Care in England and the Welsh Government.

The methodology includes a trigger for a review in the event of either an underspend exceeding 3% for two consecutive years or an overspend exceeding 3% for two consecutive years . This review would require the methodology to be suspended and submitted for renegotiation. An overspend in 2018/19 of 4.23% was followed by an underspend in 2019/20 of -3.77%, an overspend in 2020/21 of 2.39%, an underspend in 2021/22 of -8.34% and an overspend in 2022/23 of 12.64%.

In August 2023, a slight modification to the methodology was agreed to address the continuing fluctuation between overspend and underspend year on year. This revision to the methodology uses more suitable multipliers to calculate the adjusted and anticipated spend for the first and second half of the year. This methodology has been implemented for calculating the 2023/24 feescales and details of the calculations can be found on the 'Calculation of New Feescales' page