GP Practices Benchmarking Report 2017
in association with
Copyright © Kreston UK. All rights reserved.
ConfidentialityThe contents of this document are intended for selected recipients only. No part of this document should be disclosed to any third party without the written permission of Colin Haw ([email protected], 0333 123 7171).
Report contents
Page
1. Introduction 1
2. The authors and contributors 2
3. The GP Practices Benchmarking Report and how to use it 3
4. Executive summary 4
5. Income 6
6. Expenditure 11
7. Age and gender profile 17
8. Dispensing practices 23
Appendices:
1. Definitions 24
2. Practice profile and partner sessions 25
3. Income 31
4. Expenditure 33
5. Dispensing practices 37
Kreston GP Practices Benchmarking Report 2017Page 1
1. Introduction
Introduction
Welcome to the Kreston UK 2017 benchmarking report.
The statistics are compiled from 161 Kreston GP practices from throughout the UK, providing a significant range of data from which to produce average figures for a GP practice. It is necessary to split Personal Medical Services (PMS) and General Medical Services (GMS) practices due to the differential in profitability between the two contracts, and the results of this benchmarking exercise emphasise this point.
Pressure on GP practice profitability continues, mainly due to NHS England’s PMS contract value reviews and, in the case of GMS practices, the MPIG withdrawal over a seven year period from April 2014.
The Prime Minister’s Challenge Fund has been introduced to support seven day GP access. The proposed increase in patient appointment availability, with the goal of reducing A & E admissions, will prove very difficult in light of the lack of GP capacity. The Government needs to address the capacity issue to ensure that the GP system is not put under irreversible strain.
The low number of doctors moving into general practice is disturbing. NHS England needs to increase confidence in the system to attract GPs. Over the last year we have seen GP contracts moved away from GPs to hospitals and other providers. Some of the alternative bodies lack experience in relation to the management and running of a general practice contract.
From the outside, it appears that GPs are being used as political footballs and their professional bodies need to have more power in contract negotiations. The recent move to disclose GPs’ profits on their practice website, as a contractual term, is an example of an intrusion into personal information and in the present format, the information provided is meaningless . It is essential that control of NHS policies is moved away from the politicians to an independent body, similar to the banking system.
Our benchmarking report gives a detailed insight into the income and expenditure of a GP practice and the differences between the two contracts.
The survey is based on information from GP accounts ending during the tax year to 5 April 2016. Thanks go to all Kreston UK group members for submitting their data to a strict timetable. Thanks must also go to everyone in the BHP Healthcare team and my co-author, for the work put in to ensure a high quality report.
Finally, thanks must once again go to all of the Kreston GP clients. We hope that you find the report useful and interesting. Please do let us know if there are any further benchmarks or improvements that you would like to see in future reports.
Colin Haw
Chair of the Kreston UK Healthcare Group
December 2017
Kreston GP Practices Benchmarking Report 2017Page 2
2. The authors and contributors
The authors and contributors
Colin and Jenny are both members of the ICAEW Healthcare Group and together head up the Healthcare team at BHP, which deals with around 100 GP practices, in the region of 400 locum GPs, 150 dentists and other healthcare related clients including pharmacies, opticians and care homes. They are supported by a team of 30 professionals, including qualified and trainee accountants.
BHP is a founder member of the Association of Independent Specialist Medical Accountants (AISMA), a national network of accountancy firms which provides expert advice to medical practices, sessional GPs and hospital doctors.
The contributors
Bishop Fleming – Tim Godfrey, Andrew Sandiford, Steve Tucker
Duncan & Toplis – Kay Botley, Christine Newitt
EQ Accountants – Louise Grant, John Langlands
Horsfield & Smith – Glynn Warburton, Anthony Nuttall, Peter Nicol
James Cowper Kreston LLP – Louise Wickens, Robert Holland, Annette Warren
Mitchell Charlesworth – Paul Durrance
PEM – Stephen Hillyard, Kelly Bretherick, Stephen Peak, Caroline Fagence
Kreston Reeves – Clive Relf, Stephen Dawson
Kreston UK is a brand representing firms based in the UK, Ireland and Isle of Man which are each members of Kreston International, a global network of independent accounting firms. Each member is a separate and independent legal entity and as such has no liability for the acts or omissions of any other member firm. Kreston UK and Kreston International provide no services to clients and have no liability for the acts or omissions of any member firm.
Kreston GP Practices Benchmarking Report 2017Page 3
3. The GP Practices Benchmarking Report and how to use it
What is the GP Practices Benchmarking Report?
The GP Practices Benchmarking Report is intended to help the GP sector gain a deeper understanding of the financial performance of practices.
The report has been prepared from the accounts of 161 GP practices, with year ends falling in the tax year to 5 April 2016, of which 67 hold PMS contracts and 94 hold GMS contracts.
The report focuses on the key benchmarks, however, the full set of data, split between GMS and PMS practices is provided in appendices two to seven.
A detailed explanation of the definitions used throughout the report can be found in Appendix one.
Figures in brackets throughout the report refer to figures from last year’s GP Practices Benchmarking Report.
Previous benchmarking reports focussed on results per partner session and, while headline results per partner session are shown in Appendix 2, the 2017 report concentrates on results per patient. Patient numbers are actual numbers rather than weighted.
The reason for the change is a shift in the way GP practices are staffed. The ongoing reduction in GP partner capacity and sessions worked means that practice results per partner session are becoming increasingly difficult to compare.
How to use the GP Practices Benchmarking Report
GP practices may calculate their own benchmark data with reference to the definitions in Appendix one. This may be compared to the average data per contract type, PMS or GMS, provided within this report. Year on year comparisons will enable practices to identify whether movements in their performance are in line with the general trend.
Kreston GP Practices Benchmarking Report 2017Page 4
4. Executive summary
Profitability per session has increased by 15.3% in GMS practices this year to £15,682, while PMS profit per session has increased 3.6% to £16,757. However, sessional results are becoming increasingly difficult to compare due to variations in the way that practices are staffed, as a result of falling GP capacity. For this reason, the focus of the 2017 Kreston Benchmarking Report is on results per patient.
Income per patient has fallen between 2016 and 2017 across both GMS and PMS practices by 3.3% and 3.5% respectively. PMS practices remain slightly ahead, despite the recent PMS reviews, at £148.74 (£154.19) per patient compared to £145.26 (£150.16) per patient in GMS practices. Some PMS practices have negotiated funding for work carried out within their PMS contract which is in addition to the core GMS work.
Conscious of falling income, practices have made efforts to control expenditure, which has also fallen, most markedly within GMS contracts which show a fall of 5.2% to £94.12 (£99.29) per patient. PMS contract expenditure shows a fall of 3.2% to £101.15 £104.48) per patient.
Looking more closely at the detail, it is apparent that, while certain administration costs are reducing, overall staffing costs per patient are increasing, particularly in GMS practices. This is due to a shift from practices being resourced largely by GP partners to reliance on other healthcare professionals, particularly locum and salaried GPs.
Average sessions per partner have fallen in both contract types being 7.01 sessions in PMS practices and 6.78 sessions in GMS practices compared to 7.07 and 6.82 respectively in the previous year.
PMS practices continue to spend a slightly higher proportion of their income, actually achieving a greater total profit level as a result of a higher level of income through greater patient numbers. This position is attained by employing more staff and GPs to deal with the greater workload.
Overall, on a per patient basis, GMS profits have increased by 0.6% to £51.14 (£50.86) per patient while PMS profits have fallen by 4.3% to £47.59 (£49.71) per patient.
In conclusion, profits remain fairly static in comparison with the previous year. These profits are shared amongst fewer GP partners resulting in increased profit per GP partner. However, the reduction in partner numbers results in a significant increase in workload and strain on the individual partners, particularly taking into account the increased patient demand. We understand from our GP clients that their working hours per session are increasing year on year.
Overall, PMS practices continue to be more profitable than GMS practices although the gap is narrowing as the result of the PMS contract reviews takes effect. The higher earning practices will generally have higher than average patient numbers per partner and/or will earn income from outside of the PMS or GMS contract. They will also maintain good control of practice expenditure and monitor through a budgeting process.
Kreston GP Practices Benchmarking Report 2017Page 5
“profits remain fairly static in comparison with the previous year”
Kreston GP Practices Benchmarking Report 2017Page 6
5. Income
Kreston GP Practices Benchmarking Report 2017Page 7
5. Income
Both GMS and PMS practices have experienced a significant decrease in reimbursement income, of 21.5% and 23.3% respectively. Reimbursements have fallen across the board but notable reductions are seen in trainee salaries and training grants. This emphasises the continued reduction in medical students choosing General Practice as a career which also affects the healthcare capacity of the practices.
Rent reimbursements have also decreased, which is not unexpected given NHS England’s stated intention to reduce costs in this area.
Significant reductions in rates reimbursements are due to large rates refunds from local councils in 2016 as a result of rates reviews across some practices. The refunds were repaid to the NHS, who reimburse this expenditure, and therefore do not affect practice profits.
Kreston GP Practices Benchmarking Report 2017Page 8
5. Income
The proportion of income between the two contracts is comparable. The following points are noteworthy:
Seniority
Seniority ceases in 2020, new entrants to the scheme are no longer permitted from 1 April 2014. GPs currently receiving seniority will continue their entitlement with the caveat that NHS England achieves a reduction in the overall fund of 15%. Reductions to seniority payments commenced in October 2015 with compensating adjustments to contract values.
Contract payments
PMS practices remain slightly ahead, despite the recent PMS reviews, at £85.37 (£83.02) per patient compared to £83.65 (£81.17) per patient in GMS practices. Some PMS practices have negotiated funding for work carried out within their PMS contract which is in addition to the core GMS work.
Kreston GP Practices Benchmarking Report 2017Page 9
5. Income
The graphs shows the division of the sources of non-NHS income.
Last year appointment fees in both GMS and PMS practices reduced by approximately one third probably due to changes in contractual arrangements with local hospitals and Clinical Commissioning Groups and reduction in funding for these posts. This trend has reversed this year with appointment fees in PMS practices increasing by 54.9% to £1.41 (£0.91) per patient and in GMS practices increasing by 16.8% to £1.18 (£1.01) per patient possibly to subsidise other areas of falling income.
Sundry fees, comprising largely medical and insurance reports, have shown a steady decline in recent years. This, in part, reflects a downward trend in the economic environment but also a move towards requests for copies of medical records, rather than reports. Sundry fees have reduced by 20.7% in PMS practices to £1.84 (£2.32) per patient and also in GMS practices to £2.09 (£2.49) per patient. Due to the impending GDPR (General Data Protection Regulation) requirements, sundry fees are likely to fall further in the future.
Kreston GP Practices Benchmarking Report 2017Page 10
“Salaried GP and locum costs represent a major element of GP practice expenditure and
require constant monitoring and consideration at finance meetings.”
Kreston GP Practices Benchmarking Report 2017Page 11
6. Expenditure
Comparing the two contracts, PMS practices spend a larger proportion of their total expenditure on GP costs.
This is linked to historical growth funding in PMS contracts . However, in 2017, GP costs in GMS practices have risen 15.9% to £18.09 (£15.61) per patient, closing the gap between them. This may be due to difficulties in securing new partners as existing partners retire in GMS practices. GP costs in PMS practices have remained almost static at £21.09 (£21.18) per patient.
Staff costs, which include administration and nurse costs, are similar in both contracts at £46.12 (£45.44) per patient in PMS and £44.62 (£46.36) per patient in GMS. Both contract types have seen little movement in staff costs from last year. Staff costs represent the largest proportion of a GP practice’s expenditure and therefore is a key area from a management and profitability viewpoint.
Trainee salaries in PMS of £4.87 (£6.13) per patient are 82% greater than GMS of £2.68 (£4.75) per patient, reflecting a greater number of PMS training practices. It is worth noting that trainee salaries have fallen 20.6% in GMS practices and 43.6% in PMS practices, highlighting the reduction in the number of medical students opting for a career in General Practice. Trainee salaries are reimbursed by the NHS, resulting in no cost to the practice.
Kreston GP Practices Benchmarking Report 2017Page 12
6. Expenditure
Following increases in 2016, locum costs have once again increased in both contracts as GP practices struggle to fulfil the clinical sessions and deal with ever increasing patient demand. GMS practices show an increase of 11% to £4.86 (£4.38) per patient while locum costs in PMS practices have increased by 16.5% and are now also at £4.86 (£4.17) per patient.
Salaried GP and locum costs represent a major element of GP practice expenditure and require constant monitoring and consideration at finance meetings. These costs represent 17% (17%) of the total expenditure in PMS practices and 15% (12%) in GMS practices.
Kreston GP Practices Benchmarking Report 2017Page 13
6. Expenditure
Premises costs per patient in GMS practices are 22% lower than last year at £13.59 (£17.47) per patient. PMS practices have seen a 14% decrease at £13.36 (£15.45) per patient.
Rent costs have decreased by 21% in GMS practices to £7.71 (£9.77) per patient in line with the reduction in rent reimbursement. Rent costs in PMS practices show a small increase of 2.4% to £8.04 (£7.85) per patient.
Kreston GP Practices Benchmarking Report 2017Page 14
6. Expenditure
Administration costs have fallen in both contract types as practices look for cost savings. GMS costs have fallen by 1.9% to £9.76 (£9.95) per patient while PMS costs have fallen 5.2% to £10.46 (£11.03) per patient. Despite increasing medical indemnity costs, total subscription costs have fallen by just under 3%. This may reflect the reduction in GP partners. In the current year, practices have received a contribution of 51.6 pence per patient from the NHS to help towards the increasing cost of indemnity cover. The annual Care Quality Commission (CQC) subscription is now also reimbursed by the NHS.
Kreston GP Practices Benchmarking Report 2017Page 15
6. Expenditure
Kreston GP Practices Benchmarking Report 2017Page 16
Finance charges will vary depending whether the loans are in held in the partnership name, and are therefore shown within the practice accounts, or by individual partners held outside of the accounts and therefore are not reflected within the above figures.
Bank finance is an area of expertise in its own right. There are certain banks that have healthcare specialist managers who understand how GP practices operate and their funding requirements. This can ease the process of arranging bank funding.
6. Expenditure
Kreston GP Practices Benchmarking Report 2017Page 17
7. Age and gender profile
The partners age profile shows that almost 50% of GP partners are over 50. We currently see the majority of GP partners retire by age 60 which suggests that a significant number of partners will retire from partnership in the next ten years. The salaried GPs age profile shows that 83% of salaried GPs in both GMS practices and PMS practices are under 50. This indicates that there are a number of GPs available to move into partnership positions. However, a lack of confidence in future income levels and lifestyle decisions appear to be making salaried GPs reluctant to move into practice.
Kreston GP Practices Benchmarking Report 2017Page 18
7. Age and gender profile
Kreston GP Practices Benchmarking Report 2017Page 19
7. Age and gender profile
Kreston GP Practices Benchmarking Report 2017Page 20
7. Age and gender profile
Kreston GP Practices Benchmarking Report 2017Page 21
7. Age and gender profile
The gender profile of salaried GPs shows that the majority of female salaried GPs are under 50.
Kreston GP Practices Benchmarking Report 2017Page 22
7. Age and gender profile
The majority of GP registrars, in both contracts, are below the age of 35. There is little difference in the profiles of males and females across the age ranges.
Kreston GP Practices Benchmarking Report 2017Page 23
8. Dispensing practices
Dispensing Practices are GP practices which run a pharmacy contract from their surgery premises, dispensing drugs to their patients in a defined geographical area.
Generally, dispensing practices are highly profitable, with the dispensing profits being added to the general practice profits.
PMS practices are showing gross profits as a percentage of fees of 33% (last year – 33%), whilst GMS practices are at 31% (last year – 31%).
The figures will be affected by the size of practice in terms of patient numbers, irrespective of the type of NHS contract, due to the discounts available to the larger dispensaries on drugs purchases. The PMS practices reflect a slightly higher level of gross fees per practice (£758,375) compared to GMS practices (£741,505).
It is likely that gross profit returns will fall in the future due to changes in the Drug Tariff.
Kreston GP Practices Benchmarking Report 2017Page 24
Appendix 1 - Definitions
GP: General Practitioner
GMS: General Medical Services
PMS: Personal Medical Services
ICAEW: Institute of Chartered Accountants in England and Wales
Session: Represents a period of half a working day
Seniority: NHS income relating to years of service
Prescribing fees: Fees earned from personally administered drugs work
QOF: Quality and Outcomes Framework
Enhanced services: Services over and above those included in PMS or GMS contracts
Reimbursements: Expenditure reimbursed by the NHS
Training grant: Funding for training GP registrars
Appointments: Contracts for medical work outside of PMS or GMS contract
Staff costs: Administration and nursing staff salary costs
Deputising service: Out of Hours Opt Out charge and other costs to cover times of surgery closure
Out of Hours Opt Out charge: The amount paid to the NHS for cover outside of General Practice hours
Locum costs: Payments to temporary GPs
LMC: Local Medical Committee
MPIG: Minimum Practice Income Guarantee
Kreston GP Practices Benchmarking Report 2017Page 25
Appendix 2 - Practice profile and partner sessions
2017PMS
2016PMS
%Change
PRACTICE PROFILE SUMMARY - PER PATIENT
INCOME PER PATIENT 150.51 158.10 (4.8%)
EXPENDITURE PER PATIENT 101.14 104.49 (3.2%)
PROFIT - PER PATIENT 49.37 53.61 (7.9%)
PATIENT NUMBERS 9,514 9,446 0.7%
PRACTICE PROFILE SUMMARY - PER SESSION
INCOME 51,095 49,621 3.0%
EXPENDITURE 34,338 32,797 4.7%
NET PROFIT 16,757 16,824 (0.4%)
AVERAGE SESSIONS PER PARTNER 7.01 7.07 (1.0%)
NUMBER OF PRACTICES 67 64 4.7%
Kreston GP Practices Benchmarking Report 2017Page 26
Appendix 2 - Practice profile and partner sessions
2017GMS
2016GMS
%Change
PRACTICE PROFILE SUMMARY - PER PATIENT
INCOME PER PATIENT 147.86 155.26 (4.8%)
EXPENDITURE PER PATIENT 94.12 99.29 (5.2%)
PROFIT - PER PATIENT 53.74 55.97 (4.0%)
PATIENT NUMBERS 9,529 8,717 9.3%
PRACTICE PROFILE SUMMARY - PER SESSION
INCOME 42,373 41,492 2.1%
EXPENDITURE 26,942 26,534 1.5%
NET PROFIT 15,431 14,958 3.2%
AVERAGE SESSIONS PER PARTNER 6.78 6.82 (0.6%)
NUMBER OF PRACTICES 95 59 61.0%
Kreston GP Practices Benchmarking Report 2017Page 27
Appendix 2 - Practice profile and partner sessions
PARTNERS
AGE 2017PMS
2017GMS
Under 30 1.5% 0.4%30-34 0.0% 0.0%35-39 0.0% 0.6%40-44 3.7% 5.2%45-49 13.8% 10.3%50-54 13.1% 17.4%55-59 20.1% 17.8%60-64 25.4% 23.4%65+ 17.5% 18.7%
95.1% 93.8%
SALARIED GP
AGE 2017PMS
2017GMS
Under 30 2.6% 5.7%30-34 0.0% 0.0%35-39 3.9% 0.9%40-44 26.0% 14.2%45-49 27.3% 26.4%50-54 14.3% 22.6%55-59 11.7% 18.9%60-64 7.8% 7.5%65+ 3.9% 4.7%
97.4% 100.9%
GP Profiles
Kreston GP Practices Benchmarking Report 2017Page 28
Appendix 2 - Practice profile and partner sessions
MALE
AGE 2017PMS
2017GMS
Under 30 0.0% 0.0%30-34 4.6% 6.8%35-39 12.5% 10.2%40-44 11.2% 14.4%45-49 19.1% 15.7%50-54 23.7% 21.2%55-59 19.7% 23.7%60-64 6.6% 7.2%65+ 2.6% 0.8%
100.0% 100.0%
FEMALE
AGE 2017PMS
2017GMS
Under 30 0.0% 1.3%30-34 2.6% 3.5%35-39 15.5% 10.4%40-44 15.5% 20.4%45-49 21.6% 20.0%50-54 27.6% 25.7%55-59 14.7% 13.5%60-64 0.9% 3.5%65+ 1.7% 1.7%
100.0% 100.0%
Partner Profiles
Kreston GP Practices Benchmarking Report 2017Page 29
Appendix 2 - Practice profile and partner sessions
MALE
AGE 2017PMS
2017GMS
Under 30 0.0% 0.0%30-34 14.3% 8.7%35-39 23.8% 23.9%40-44 4.8% 21.7%45-49 9.5% 19.6%50-54 14.3% 10.9%55-59 14.3% 6.5%60-64 19.0% 4.3%65+ 0.0% 4.3%
100.0% 100.0%
FEMALE
AGE 2017PMS
2017GMS
Under 30 5.4% 1.7%30-34 30.4% 18.3%35-39 28.6% 28.3%40-44 17.9% 23.3%45-49 12.5% 18.3%50-54 5.4% 5.0%55-59 0.0% 3.3%60-64 0.0% 1.7%65+ 0.0% 0.0%
100.0% 100.0%
Salaried GP Profile
Kreston GP Practices Benchmarking Report 2017Page 30
Appendix 2 - Practice profile and partner sessions
MALE
AGE 2017PMS
2017GMS
Under 30 25.0% 23.5%30-34 40.0% 23.5%35-39 15.0% 17.6%40-44 20.0% 17.6%45-49 0.0% 17.6%50-54 0.0% 0.0%55-59 0.0% 0.0%60-64 0.0% 0.0%65+ 0.0% 0.0%
100.0% 100.0%
FEMALE
AGE 2017PMS
2017GMS
Under 30 27.3% 20.8%30-34 36.4% 37.5%35-39 18.2% 12.5%40-44 9.1% 12.5%45-49 9.1% 4.2%50-54 0.0% 8.3%55-59 0.0% 4.2%60-64 0.0% 0.0%65+ 0.0% 0.0%
100.0% 100.0%
GP Registrar Profile
Kreston GP Practices Benchmarking Report 2017Page 31
Appendix 3 - Income
2017PMS
2016PMS
%Change
INCOME - PER PATIENT
NHS INCOME
Seniority 1.91 2.22 (13.8%)
Prescribing fees 5.33 7.53 (29.3%)
QOF 13.09 13.54 (3.3%)
Enhanced services 20.77 21.22 (2.1%)
PMS contract 85.37 83.02 2.8%
Less: Employer’s pension (partners) (4.89) (5.21) (6.2%)
121.58 122.32 (0.6%)
REIMBURSEMENTS
Rent 11.14 11.71 (4.9%)
Rates and Water 1.36 2.98 (54.6%)
Refuse 0.09 0.11 (14.5%)
Trainees salaries 5.44 6.11 (10.8%)
Training grant 0.88 1.03 (14.2%)
Other income 3.25 6.94 (53.2%)
22.16 28.88 (23.3%)
OTHER INCOME
Sundry fees 1.84 2.32 (20.7%)
Interest received 0.03 0.02 43.4%
Rent 0.52 0.44 18.2%
Appointments 1.41 0.91 53.9%
Other income 2.98 3.21 (7.4%)
6.77 6.91 (2.0%)
TOTAL INCOME - PER PATIENT 150.51 158.10 (4.8%)
Kreston GP Practices Benchmarking Report 2017Page 32
Appendix 3 - Income
2017GMS
2016GMS
%Change
INCOME - PER PATIENT
NHS INCOME
Seniority 2.13 2.45 (13.2%)
Prescribing fees 6.13 8.57 (28.5%)
QOF 12.59 13.58 (7.3%)
Enhanced services 19.79 20.83 (5.0%)
GMS contract 83.65 81.17 3.1%
Less: Employer’s pension (partners) (5.90) (5.96) (1.1%)
118.39 120.64 (1.9%)
REIMBURSEMENTS
Rent 11.31 14.07 (19.6%)
Rates and Water 2.12 3.43 (38.3%)
Refuse 0.24 0.09 176.7%
Trainee’s salaries 2.30 4.68 (50.9%)
Training grant 0.86 0.92 (6.2%)
Other income 6.19 6.14 0.8%
23.02 29.33 (21.5%)
OTHER INCOME
Sundry fees 2.09 2.49 (16.1%)
Interest received 0.01 0.01 6.2%
Rent 0.43 0.25 70.2%
Appointments 1.18 1.01 17.6%
Other income 2.73 1.52 78.9%
6.45 5.29 21.9%
TOTAL INCOME - PER PATIENT 147.86 155.26 (4.8%)
Kreston GP Practices Benchmarking Report 2017Page 33
Appendix 4 - Expenditure
2017PMS
2016PMS
%Change
EXPENDITURE - PER PATIENT
STAFF COSTS
Salaries and national insurance 41.92 40.90 2.5%
Employer’s pension costs 4.20 4.54 (7.5%)
46.12 45.45 1.5%
GP COSTS
* Deputising service 3.93 3.28 19.8%
Locum costs 4.86 4.17 16.6%
Salaried GPs 12.30 13.73 (10.4%)
21.09 21.18 (0.4%)
TRAINING COSTS
Trainee’s salaries 4.87 6.13 (20.6%)
MEDICAL EXPENSES
Drugs and medical supplies 4.12 3.98 3.6%
PREMISES COSTS
Rent 8.04 7.85 2.4%
Rates and water 1.29 3.30 (61.0%)
Refuse 1.14 1.79 (36.3%)
Light and heat 1.08 1.01 7.3%
Insurance 0.47 0.26 82.0%
Repairs 1.34 1.24 8.8%
13.37 15.44 (13.5%)
*including Out of Hours opt out charge
Kreston GP Practices Benchmarking Report 2017Page 34
Appendix 4 - Expenditure
2017PMS
2016PMS
%Change
EXPENDITURE - PER PATIENT (continued)
ADMINSTRATION COSTS
Telephone 0.68 0.68 1.0%
Printing, postage and stationery 1.48 1.54 (4.3%)
Computer expenses 0.30 0.30 (1.2%)
Equipment leasing 0.32 0.33 (2.2%)
Subscriptions 2.84 2.92 (2.8%)
Legal and professional charges 0.46 0.75 (38.7%)
Accountancy 1.30 1.33 (2.4%)
Course fees 0.19 0.23 (19.6%)
LMC levies 0.39 0.40 (3.4%)
Payroll charges 0.05 0.03 59.0%
Depreciation and grants released 0.55 0.62 (11.9%)
Sundry expenses 1.90 1.90 (0.1%)
10.45 11.04 (5.3%)
FINANCES CHARGES
Bank charges and interest 0.11 0.31 (63.7%)
Loan interest 1.02 0.96 5.9%
1.13 1.27 (11.1%)
TOTAL EXPENDITURE - PER PATIENT 101.14 104.49 (3.2%)
Kreston GP Practices Benchmarking Report 2017Page 35
Appendix 4 - Expenditure
2017GMS
2016GMS
%Change
EXPENDITURE - PER PATIENT
STAFF COSTS
Salaries and national insurance 40.82 41.92 (2.6%)
Employer’s pension costs 3.80 4.44 (14.3%)
44.63 46.36 (3.7%)
GP COSTS
* Deputising service 3.64 3.61 0.8%
Locum costs 4.86 4.38 11.1%
Salaried GPs 9.59 7.62 26.0%
18.10 15.60 16.0%
TRAINING COSTS
Trainee’s salaries 2.68 4.75 (43.6%)
MEDICAL EXPENSES
Drugs and medical supplies 4.43 3.58 23.7%
PREMISES COSTS
Rent 7.71 9.77 (21.1%)
Rates and water 2.12 3.37 (36.9%)
Refuse 0.70 0.93 (25.3%)
Light and heat 1.10 1.29 (14.8%)
Insurance 0.45 0.28 59.5%
Repairs 1.51 1.83 (17.4%)
13.59 17.47 (22.2%)
*including Out of Hours opt out charge
Kreston GP Practices Benchmarking Report 2017Page 36
Appendix 4 - Expenditure
2017GMS
2016GMS
%Change
EXPENDITURE - PER PATIENT (continued)
ADMINSTRATION COSTS
Telephone 0.72 0.79 (9.2%)
Printing, postage and stationery 1.40 1.44 (2.6%)
Computer expenses 0.32 0.33 (1.5%)
Equipment leasing 0.31 0.29 8.3%
Subscriptions 2.30 2.36 (2.5%)
Legal and professional charges 0.50 0.60 (17.5%)
Accountancy 1.24 1.38 (10.2%)
Course fees 0.16 0.26 (38.4%)
LMC levies 0.39 0.45 (13.9%)
Payroll charges 0.03 0.02 49.6%
Depreciation and grants released 0.42 0.53 (20.5%)
Sundry expenses 1.97 1.50 31.0%
9.75 9.94 (1.9%)
FINANCES CHARGES
Bank charges and interest 0.15 0.41 (63.2%)
Loan interest 0.80 1.17 (32.1%)
0.95 1.58 (40.1%)
TOTAL EXPENDITURE - PER PATIENT 94.12 99.29 (5.2%)
Kreston GP Practices Benchmarking Report 2017Page 37
2017PMS
2016PMS
%Change
DISPENSING PRACTICES
NUMBER OF PRACTICES 9 13 (30.8%)
GROSS FEES - PER PRACTICE 758,375 743,382 2.0%
COST OF DRUGS - PER PRACTICE (507,405) (498,008) 1.9%
DISPENSING PROFIT - PER PRACTICE 250,970 245,374 2.3%
DISPENSING PROFIT AS A PERCENTAGE OF GROSS FEES 33.09 33.01 0.3%
Appendix 4 - Dispensing practices
Kreston GP Practices Benchmarking Report 2017Page 38
Appendix 4 - Dispensing practices
2017GMS
2016GMS
%Change
DISPENSING PRACTICES
NUMBER OF PRACTICES 23 23
GROSS FEES - PER PRACTICE 741,505 658,481 12.6%
COST OF DRUGS - PER PRACTICE (508,187) (453,252) 12.1%
DISPENSING PROFIT - PER PRACTICE 233,317 205,229 13.7%
DISPENSING PROFIT AS A PERCENTAGE OF GROSS FEES 31.47 31.17 1.0%
Kreston GP Practices Benchmarking Report 2017Page 39
About the Kreston UK Healthcare Group
The UK firms that have participated in this report are as follows:
Derbyshire and Yorkshire BHP Chartered Accountants Colin Haw 01246 232 121 [email protected]
South West and Bishop Fleming Tim Godfrey 01803 291100 [email protected] Midlands
East Midlands Duncan & Toplis Kay Botley 01529 303773 [email protected]
Scotland EQ Accountants Louise Grant 01382 312100 [email protected]
North West Horsfield & Smith Glynn Warburton 0161 7615231 [email protected]
Oxfordshire, Thames James Cowper Kreston LLP Louise Wickens 0118 9590261 [email protected] and the South
North West Mitchell Charlesworth LLP Paul Durrance 0151 2552300 [email protected]
Cambridge PEM Stephen Hillyard 01223 728222 [email protected] London and South East Kreston Reeves Clive Relf 01227 768231 [email protected]
Kreston UK is a brand representing firms based in the UK, Ireland and Isle of Man which are each members of Kreston International, a global network of independent accounting firms. Each member is a separate and independent legal entity and as such has no liability for the acts or omissions of any other member firm. Kreston UK and Kreston International provide no services to clients and have no liability for the acts or omissions of any member firm.
The Kreston UK Healthcare group is a network of independent accounting and business advisory firms in the UK that share a common interest and specialisation in the Healthcare sector.
John Langlands
John is a partner at
EQ with over 40
years experience.
Louise Grant
Louise is a partner at
EQ with over 14
years experience.
John and Louise spearhead our services to GP practices and Locum GPs within EQ Healthcare
which is a specialist brand of EQ Accountants LLP. They are supported by a highly trained team
who take a genuine interest in our clients and tailor our service to suit the needs and demands of
each business. EQ has a strong reputation for a quick, friendly and reliable service coupled with
imaginative solutions and positive encouragement to our clients.
For more information on what we do or what our clients think, you can visit our website via
www.eqaccountants.co.uk/healthcare.