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NHS payments to practices in the East of England

Matt Davey / Unsplash

In this resource, we explore structural inequalities in primary care at the ICB level in the East of England. We provide data on NHS payments to GP surgeries, payments per weighted patient and patient satisfaction, showing differences across socioeconomic groups.




Cameron Appel
John Ford

The ICB with the largest disparity in total payments per weighted patient between practices predominantly serving patients in the lowest and highest deprivation quintiles was Suffolk and North East Essex, with a difference of £46.38; the ICB with the most equitable payments was Bedfordshire, Luton and Milton Keynes, with a difference of £17.59.

NHS payments to GP surgeries

This data explorer shows how NHS payments to GP surgeries varies across socioeconomic groups, allowing you to select the ICB of interest, as well as the payment type.

Payments per weighted patient by type

This data explorer shows the proportion that each category contributes to total payments in each quintile, allowing you to select the year and ICB of interest. Payments are divided into the following categories:

  • Global Sum: The main payment to practices based on each practice’s registered patient list. This is adjusted according to the Carr-Hill Formula to take into consideration differences in the age and sex of the patients, as well as any in nursing or residential care, additional patient need due to medical conditions, patient turnover and unavoidable costs based upon rurality and staff market forces for the area. 
  • IT and premises: Payments cover certain premises, information management, and technology services costs. 
  • Contracted services: Payments cover: essential services (deemed mandatory for a practice to deliver to registered patients and temporary residents in its practice area”; out-of-hours services; additional services, (which include specific other clinical services that a practice is assumed to provide but can opt out of, for example, minor surgery); enhanced services (which include some vaccination programmes and a health check scheme for people with learning disabilities) and locally commissioned services (locally set services that practices can also opt in to). Unlike other GP services, these might also be commissioned by non-NHS organisations such as local authority public health departments. Examples include services for people who are sleeping rough or mental health support programmes.” 
  • Quality Outcome Framework (QOF): A performance-based payment system for general practices in England. It rewards practices for achieving improvements in the quality of care they provide to patients. QOF payments are based on a set of indicators that measure a practice’s performance in a variety of areas. 
  • Prescribing: Payments cover prescribing fee payments, dispensing fee payments and the reimbursement of drugs. 
  • Primary Care Organisation (PCO) payments, training and other: Payments by the local ‘primary care organisation’, ie, the CCG/ICB or NHS England depending on delegation of powers. Payments in this category include, for example, locum allowances and appraisal costs.”

We see that the trend at the ICB level generally mirrors that of the national level, whereby practices serving patients in less deprived areas tend to receive relatively more payments in the prescribing category.

Patient satisfaction

This chart shows how patient satisfaction with GP practices has changed over time by socioeconomic group across England, as measured by the GP Patient Survey: