How are Doctors Paid in the UK?

How are doctors paid in the UK?

It depends on the type of doctor.

Hospital Doctors

Hospital doctors are paid through a combination of a basic salary (which increases with experience and rank), and additional payments for extra hours, nights, weekends, and on-call shifts.

In the UK’s National Health Service (NHS), this is often calculated using a pay scale system, with salaries broken down by role, such as a resident (previously called junior) doctor, specialty doctor, or consultant.

While a basic salary covers the standard work week, additional compensation is given for unsociable hours and other commitments.

There is no incentive to see more patients, or do more tests, procedures or operations – leading to a good use of their resources.

Senior hospital consultants can earn over £120k a year from the NHS. Many hospital consultants augment their NHS salaries by doing private practice and medicolegal work. So very high salaries are possible.

Components of hospital doctor pay

Basic salary: This is the foundation of a hospital doctor’s pay, based on their specific role, grade, and years of experience. For example, a consultant’s basic salary is higher than a resident doctor’s, and a doctor’s salary increases as they move up the pay scale.

Additional hours: Doctors who work beyond a 48-hour week receive extra pay for those hours. This is often calculated and paid through a ‘banding’ system; where pay is adjusted based on unsociable hours, on-call commitments, and workload.

Night and weekend (and bank holiday) work: For example, hospital doctors receive enhanced rates for working nights and weekends. There can be a 37% enhancement for night shifts.

Location: In some areas, like London, a London weighting allowance is added to account for the higher cost of living.

Pay for other types of doctor

General Practitioners (GPs)

GPs are paid differently depending on their employment model.

Many (especially senior) GPs are called ‘partners’ (of the practice) and are self-employed; and paid by the number of patients registered on their list – through a ‘General Medical Services (GMS)’ contract.

The patient numbers are submitted to NHS England four times a year. Under the GMS contract – as with hospital doctors – there is no incentive to see, investigate or treat patients; encouraging a balanced healthcare provision and efficient use of resources.

However, GPs can receive incentive payments for undertaking work outside the GMS contract, e.g. via the Quality and Outcomes Framework (QOF) which encourages preventative medicine.

Most GP buildings are owned by the GP partners.

Practices also employ ‘salaried’ GPs (i.e. have a salary), and long or short-term locums.

Salaried GPs are employees (of the partners) and paid a set salary; whilst partners in a practice have their earnings determined by the practice’s business arrangement.

The latter are paid more, to reflect the transient ‘on-demand’ nature of their work, and lack of job security.

GPs practices are small businesses

Other staff are employed in GP practices, including practice managers, nurses, an IT manager (in bigger practices), administration staff and cleaners. They are also paid for by the income from the patients registered.

Other senior health professionals may also work there – including physician associates (PAs), advanced nurse practitioners (ANPs) and advanced clinical practitioners (ACPs) – who also see patients independently; and paramedics, who may do home visits.

So GP practices are actually small businesses that must make money, to pay all their staff. Other ways GPs earn money include onsite pharmacies, and doing medical examinations for insurance companies.

A senior GP can earn over £120k per year from the NHS. There are also few private GPs in the UK though this is not a widespread system.

Private Practice

In the private sector, payments to doctors are based on agreements between the healthcare organisation and insurance companies – with different companies paying different rates for the same service.

Pay is usually given based on piecemeal approach, e.g. fixed sums are charged for an outpatient appointment, procedure or operation.

This money may come from a patient’s insurer (if they have one), or directly from the patient (if they don’t).