Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, pursuant to the Answer of 11 March 2025 to Question 35425 on General Practitioners: Finance, whether data other than the (a) Standardised Limited Long-Standing Illness and (b) Standardised Mortality Ratio is used to calculate the formula; how unavoidable costs based on geographical area are calculated; what the additional costs are of delivering services in rural areas; and how those additional costs are calculated.

Global sum payments to general practices (GPs) are based on the number of patients registered at each GP. The Carr-Hill formula adjusts these payments to take account of the differences in workload between practices, over the differences due to variations in the number of registered patients. As well as the Standardised Limited Long-Standing Illness and Standardised Mortality Ratio, the formula uses data on the number of patients in each age-sex group, the number of patients in nursing and residential homes, and the number of new patient registrations.

The two components of the unavoidable costs adjustments in the formula are the staff market forces factor, to take account of the higher cost of employing staff in some parts of the country, estimated from earnings data, and the higher cost of providing services in rural areas, such as longer travel times for patients’ home and care home visits. The rurality adjustment is based on GPs’ expenses data, the distance from the patients’ homes to the GP surgery, and population density.