What are the differences between NHS and private GPs?
Updated: Nov 29, 2019
In the UK, NHS GPs have a contract with a Health Board (in Scotland) or a CCG (in England) in order to deliver what we call primary care services (that is General Practice) to a population of patients who register with them. They are paid to do this, and the pay is linked to a lot of different things like size of the population, deprivation in the area, age of patients and chronic disease. They are also paid for doing things like flu vaccination, child immunisations, smears, contraception, minor surgery.
Changes in the GP contract, plus some historical differences in the way practices were funded, means there are huge variations in what each practice earns.
On average the NHS pays GPs £152 per patient per year. That is just £13 per month to provide uncapped access to GP and Nurse appointments, as well as prescription services, house visits, tests and referrals. An A&E appointment costs £150 a time to the taxpayer, more than the amount that a GP practice receives per patient per year. If you look at the average number of consultations being around seven per year you can see that General Practice is great value for the Government! However, it is becoming unsustainable for lots of practices, who are facing rising business costs but no increase in funding.
Traditionally GP practices are run by a group of Partners, who are self-employed GPs. They run it the same way as any business and they have to use their income from the contract to pay all of their staff and pay the bills. Some product and building costs are reimbursed in their income from the Government. You will also find that Partners employ other GPs on a salary and also use ad hoc “locum” GPs to cover sickness, holidays and maternity.
On the other hand, Private GPs are self-employed GPs who choose when they work and what services they provide. They run a business and the services are paid for by the patient. Due to cuts in NHS funding, there are quite a lot of specialities in health care that are now run privately- Examples include Podiatry/Chiropody, Physio, Dentistry.
So what do each of them do?
NHS surgeries provide face to face and phone consultations, and also home visits. They also run repeat medication prescribing, referrals to specialists, and monitor people who have chronic diseases. Within a practice there will be a number of attached services, some provided by the practice itself (e.g practice nursing duties) and some provided by the Health board/CCG (Health visitors, District Nurses, Community Midwifery).
Patients register with a local surgery of their choice, as long as they have capacity to take on new patients. Those patients can then book appointments to see the GP or Nurse free of charge. There is no cap on the number of contacts you can have with your NHS GP
The service that a private GP offers may vary from clinic to clinic and the patient pays for the GPs time. They can provide everything that an NHS practice provides but there may be certain services that a private GP chooses not to do, for example: house visits, pregnancy care, end of life care or drug misuse problems. Some may provide minor surgery, ear syringing and joint injections, but some may not. There may also be variation in whether they have additional staff, like nurses, in the clinic. So you may find they do the nursing duties themselves, like taking blood or doing swabs.
Private GP services have been growing over the last 15 years, with a number of providers in the market. Some provide exclusively video consultations, some provide face to face consultations in a local clinic and some only provide to the corporate sector.
Private GP appointments tend to be longer, or at the very least the length can be dictated by the patient as they are paying for the time they “use”.
Regarding Prescriptions – if you receive a prescription on the NHS in Scotland you will not have to pay for it. In England, you do have to pay a standard prescription fee of £8.80 per item. However, if you are on regular medications for chronic illness you can apply to have this fee reduced. If you go to a private GP and they give you a prescription, they may or may not charge you an administration fee for it. Then you will be charged the cost of the drug at the Pharmacy, and the Pharmacy may or may not add an administration fee to this also.
How do they refer you to see a specialist? I have done a more detailed article on this but to summarise; both NHS and private GPs can refer you to see NHS and private Specialist Consultants.
I have summarised all of the main similarities and differences between NHS and private practices. You will find variation between all of your local NHS practices, and also your private clinics. If you need a detailed summary of their services please refer to their website.