ARTICLE

17 a Day: income is fixed, workload is soaring

A median 10,000-patient GP practice handles roughly 230 appointments and contacts every working day. Work through the 2025/26 contract line by line and only 17 of them are funded: the QOF reviews, vaccinations and health checks that actually earn the money. Around 109 a day are unavoidable illness and complex care. The other 104 are preventable, effectively unpaid work.

This article shows the full workings: how the 17-a-day theoretical minimum is derived from QOF upper thresholds, the vaccination programmes, learning disability health checks and the Enhanced Access minutes, what it would take to staff it (about 0.19 GP WTE and 0.75 nurse or HCA WTE), and why seeing more patients never pays more. It closes with the strategic question: how much of the preventable, socially-rooted demand, 40 to 50% of GP time, could be met somewhere better than a GP appointment?

What you get

• The day-in-the-life split of a median practice: 230 contacts, 17 funded, ~109 unavoidable, ~104 preventable
• The full derivation of the 17-a-day funded minimum, programme by programme, with weekly counts
• The staffing implication: roughly 0.19 GP WTE plus 0.75 nurse or HCA WTE for the entire funded workload
• Every contract value and assumption footnoted to its published source