The mechanisms for funding primary care are complex, due to the historical legacy of the many changes in UK general practice, and can be difficult to understand. This article gives a basic outline of how primary care is funded and where individual practices earn income. It explains several of the financial and contractual terms for GPs and discusses some of the current issues in funding. Although much is similar, mechanisms underlying GP funding differ between the four home nations. This article focuses on primary care funding in England. Where does the money for general practice come from? The NHS is almost entirely funded through general taxation and National Insurance contributions. User charges, such as prescription charges, contribute only 1.2% of NHS funding, and hence, the NHS is often described as 'free at the point of use' (McKenna et al, 2017). The total NHS budget in 2016-17 was ￡122.5 billion. Of this, roughly 7% was spent on primary care (NHS England, 2016). Box 1 briefly considers differences in general practice funding in other countries. The difference between general practice and other primary care services Although GP partners are thought of as working for the NHS, they are technically independent contractors providing services to the NHS. The services they provide, and payments they receive, are agreed through a variety of contracts. Payments are made based on the fulfilment of contractual obligations. Partnerships can also derive income from various sources in addition to NHS contracts. The profit remaining after expenses, staffing costs and other overheads can be divided between the partners based on profit-sharing agreements.
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