How are Doctor's surgeries funded / ran?

[navybean]

I'm in Scotland and just wondered. Our GP practice is ALWAYS under strain. However none of the Doctor's work full time. There's about 6 of them and I think 4 are partners.

They are private businesses (usually a partnership) who have NHS contracts to provide specific services.

As the pp said they are a business with essentially one customer - the government.

They will get funding from gov that they use for salaries, premises, consumables, utilities etc and then I think the GPs who are the owners (partners) take a share of what's left over.

It's a poor business model as they are totally dependent on one funding stream.

As standard full time hours for GPs tends to be 4 days too, so they aren't necessarily as part time as it may seem

I see. I wonder if they get funding based on the number of patients?

I do always think 10 mins for an appt and to write the notes is not enough and there's can be a whole load of admin on the back of an appt too.

Interesting

I was no.28 recently in the queue for an appt.

90% of them are privately owned and have contracts with the government, a doctors session is 4hrs 20 mins and the can work two per day, so effectively could do ten sessions a week but I no very very few doctors that do this! Some of them will locum to make their money up so choose not to work that day for example! Sessions aren’t amazingly paid regardless of what people think tbh!

And also 'part time' GP hours probably equate to about normal full time work. My 'half day' routinely runs from before 8 until 4, and full days are not uncommonly 12 hour days. So if you are working 3 days a week you are already at 36 hours or so before adding on teaching / training and CPD which is all generally done in our own time.
The other issue is rooms. Our surgery was purpose built at a time when we didn't have physios, mental health workers, OTs, multiple nurses, pharmarcy teams etc etc - they all need rooms to work from, which means GPs are hot desking and there isn't physically room at the inn some days!

And funding streams are through lots of different ways, patient list size, QOF, flu vaccines, etc etc

Practices are funded in a few ways depending on what the practice wants to opt into. Not all GPs will be partners, some will be locums and some salaried staff.

There are a few mechanisms or contracts by which they can earn money - including payments per patient for particular activities that need encouraging on a population level to improve outcomes for certain conditions or groups.

The reason many work 4 days is that they are long days, and it's extremely hard work - with a lot of work taking place outside of their "working hours". Burnout amongst GPs is at an all time high.

Populations for each practices register area have grown hugely, and so has the complexity of what we expect practices to deliver. They simply can't keep up.

Also keep in mind there is a difference between part time in front of patients and part time work. I think it’s a bit like teachers. Teachers teach 9-3 and are perceived to get school holidays ‘off’ so the general public assumes they work ‘part time’. Like teachers, clinical staff have patient facing work, but they also have to write up notes and chase test results and have meetings and supervise clinical trainees and do research and manage budgets and staff rota and publish research and attend conferences and CPD. It’s a huge amount of work outside of just seeing patients.

Thanks all very interesting!