Behind CLOSED DOORS

What really goes on at your local surgery, and how are decisions made? GP and practice partner Dr Helen Wall reveals all

Many of us visit our GPs several times a year. They often know more about our lives than our loved ones do. But how clued-up are we about how they work? From discovering how your surgery is funded to revealing when it's OK for doctors to break confidentiality rules, Dr Helen gives us the low-down.

It's like a small business

There is a lack of understanding about how general practice is run and funded. GP surgeries are independent businesses with an NHS contract that sets out core things a practice must do. Most partners are GPs - they make key decisions, and share responsibility for the financial and operational running. If the books don't balance at the end of the month, the partners take home less pay. There's so much unseen work, and squeezing this in around seeing patients means GP partners often work long hours.

GPs spend from a pot of cash

Each practice gets a set amount of money to spend. The total depends on the number of registered patients and a formula based on their age, sex and health needs. In 2023/24, this was on average £102.28 per person annually-whether that patient attended the practice once or 100 times. Extra money can be 'earned' by meeting targets. For example, ensuring all registered patients with heart disease have optimal blood pressure. This income goes into the practice pot used for staff, rent and equipment costs. Salaried GPs receive a set yearly salary, and GP partners take home what's left when all bills have been paid.

Referrals need a good reason