Changes to the 2023/24 GMS contract for GPs and what will this mean for profits?

Details of the GMS contract for 2023/24 for GPs in England have been announced. The goal is improving patient experience and satisfaction by freeing up workforce capacity through significant changes to the Impact and Investment Fund (IIF) and through the QOF Quality Improvement (QI) modules.

2023/24 is the final year of the five-year framework agreement. NHS England will engage with various stakeholders to set out next steps for primary care.

Financial headlines:

1. Global sum increased by £2.58 per weighted patient from £99.70 in 2022/23 to £102.28 in 2023/24.

2. The opt out of hours deduction remains at 4.75% in 2023/24, equating to £4.86.

3. The value of each QOF point has increased to £213.43, although the contractor population index has also increased  from 9,374 in 2022/23 to 9,639 in 2023/24.

4. HPV payment will continue to be paid at £10.06 per dose administered.

5. Weight Management Enhanced Service will continue into 2023/24, retaining the £11.50 referral payment.

6. Network Contract DES 2023/24 (paid to PCN).

    a. Core PCN funding £1.50 per registered patient per year.

    b. Clinical Director contribution £0.729 per registered patient.

    c. Staff reimbursements for the reimbursable roles, paid from April 2023 or following employment.

    d. Enhanced Access £7.578 per PCN adjusted population.

    e. Care home premium £120 per bed per year.

    f. Investment and Impact Fund (IIF) Amount payable dependent on achievement.

    g. PCN Leadership and Management Payment £0.684 per PCN adjusted population.

    h. Capacity and Access Support Payment £2.765 per PCN adjusted population.

    i. Capacity and Access Improvement Payment dependent on achievement.

What will this mean for profits?

• Global sum (illustration based on 10,000 weighted patients).

Global Sum 2022/23 income £997,000, out of hours opt out £47,357, net income £949,643.
Global Sum 2023/24 income £1,022,800, out of hours opt out £48,583, net income £974,217.
So, if patient numbers remain static, this is a net increase of £24,574 or 2.58%.

• The increase of the value of QOF points will result in an increase of 2.83%.

• If you’re dispensing, your profits may have decreased in 2021/22 as a result of a reduction in dispensing fees by 15% from 1 October 2021. Whilst this rate increased from 1 October 2022, the rate has reduced again from April 2023, which will affect profits in the next financial year.

• Increase in living costs:

  • Drug costs – drug costs have increased significantly, and it takes experience and time to look around for the best prices and ensure ordering is effective. Make sure you have the right people ordering to get this as efficient as you can.

  • Light and heat – with the huge increases in energy prices in recent years and little opportunity to move around, this is likely to have had a significant impact in the 2023 accounts, although hopefully this will start to calm down now that the energy price cap is starting to come down.

  • Staff wages – staff retention is important and therefore it’s imperative that employees are remunerated appropriately, and these rates are reviewed, especially in line with national minimum and living wage increases. With pressures from elsewhere in the public sector there’s undoubtedly pressure to award pay rises. Without the increase in funding from NHS the effect of pay awards is a reduction to profits.

  • Overheads – the cost-of-living crisis has meant that many overheads have also increased, again having a negative effect on profits.

What can you do?

• It’s important to budget for the year, keep an eye on income and costs and ensure that this is sustainable for cashflow.

• Prepare a cashflow forecast to get ahead of the situation so you can be prepared.

• Consider ways to limit costs and increase income and services offered.

• Consider whether drawings are sustainable.

• Talk to your tax advisor about reducing your tax payments on account if profits are going to be lower.

• Mitigate your tax liabilities by planning effectively – individuals should think about using allowances, making tax efficient investments, charitable donations.

• Businesses can make use of Annual Investment Allowance (100% capital allowances) on capital investment.

• Speak to your advisor if your business has a non-March year end as you’ll be affected by the basis period reform. For an overview, please see our blog Income tax basis period reform for GP partners.

Need help?

For more information about accounts and tax for GP practices, or if you’d like us to assist you with any forecasting or tax planning, please get in touch with your usual contact. You can find contact details on the Our People section of our website. Alternatively, call 0330 024 0888 or email enquiry@larking-gowen.co.uk.

Louise Dean