Portfolio GP Roles: Teaching, Appraising, Examining and What They Pay

The short answer

Most GPs who build a portfolio do it with a mix of education, quality and regulation, and one or two outside interests. The table puts the published figures side by side. Where a figure comes from a single advert or one university, it is an example, not a going rate.

Why GPs build a portfolio

The reasons GPs give are practical ones.

• Variety. Ten sessions of back-to-back surgeries is the hardest version of the job to sustain. A session of teaching or appraisal uses the same experience in a different way.
• Resilience. Income from more than one source matters to a locum whose bookings can dry up, and to a partner whose practice income can fall.
• A route somewhere. Training, appraisal and leadership roles each lead to more senior ones, and many of them value the clinical work you already do.

The trade-off is that every extra role brings its own paperwork, its own tax treatment and sometimes its own indemnity question. Those are covered at the end.

Teaching and training

GP trainer

A GP trainer is the clinical and educational supervisor for a GP specialty trainee placed in their practice. You need to be approved by your deanery, which usually means some years' experience as a GP, a recognised trainers' course or a postgraduate certificate in medical education, and a practice that meets the training standards.

Pay. The trainer grant, formally the GP clinical supervision grant, is £10,796.91 a year for each ST1, ST2 or ST3 trainee on the 2025/26 rate, paid monthly to the practice through PCSE, not to the trainer. Deanery pages also list a CPD allowance of £750 a year for some approved trainers, and a separate grant for supervising a foundation doctor. Check your own deanery's page for the 2026/27 figure.

A partner shares in the grant through the practice's profits. A salaried GP who trains should agree in their contract how the grant is reflected in their sessions or pay.

Training programme director

Training programme directors run a GP training scheme's teaching programme and support its trainees, usually for a few sessions a week. Posts are advertised by NHS England's regional workforce teams. One advertised in Leeds in 2024 was paid at £114,101 a year, pro rata to the sessions worked, on the GP educator pay scale.

Teaching medical students

Medical schools pay GPs and practices to teach students, both in practice placements and in tutorials on campus or online. Rates are set by each university, and they vary widely. At the University of Glasgow, for example:

• tutorials and communication skills teaching pay £160 to £200 a session
• practice-based teaching for first and second years pays £130 a session
• clinical placements pay £170 a day per student, to the practice

Some of these are paid to the practice through the health board, and some to the tutor personally by the university, so check which before you agree a rate with your partners. Contact the general practice teaching unit at your nearest medical school to find out what they need.

Examining

Medical school OSCEs

Medical schools need clinicians to examine their objective structured clinical examinations, usually a few days a year. The University of Glasgow pays GP examiners £200 a session, and English schools pay similar amounts: at the University of Manchester it is around £200 to £250 a session, in our own experience. Schools usually ask examiners to complete their training first.

MRCGP

The RCGP's examiners for the Simulated Consultation Assessment are working GPs. The College has said they are paid to cover their time out of practice, but it does not publish the rate. You need to be a Member or Fellow in good standing, fully registered and revalidated, and to commit to induction, training and quality assurance. Recruitment opens only when the College needs examiners, and it posts updates on its examiner page.

Appraisal, quality and regulation

GP appraiser

Appraisers carry out the annual appraisals every licensed GP needs for revalidation. In England they are recruited by NHS England's regional appraisal teams and trained before they start.

Pay. NHS England pays a fee per appraisal. An NHS England Midlands advert in 2023 offered £584 per appraisal, plus superannuation if applicable. Ask your local appraisal team for the current fee and how many appraisals a year they expect.

CQC specialist adviser

The Care Quality Commission uses practising GPs as specialist advisers on its assessments of general practice, much of it now done remotely. Recent adverts set the rate at £540 a day, including holiday pay, ad hoc and on an as-needed basis. You can do it as a casual worker in your own time, or on secondment if your practice agrees. The advert asks for at least five years as a GP since qualifying, a current licence and a place on the performers list.

Medical examiner

Since the medical examiner system became statutory in September 2024, every death in England and Wales not referred to a coroner is scrutinised by a medical examiner, and GPs are among the doctors who do it. Posts are run by NHS trusts and usually done in short sessions.

Pay. Some trusts pay by the hour on their bank: Milton Keynes University Hospital advertised for a GP medical examiner at £75 an hour in 2024. Salaried medical examiner sessions are commonly paid on the consultant scale, pro rata: £113,565 to £150,569 a year full-time in 2026/27.

Medico-legal work

Expert witness

GPs give expert evidence on general practice standards, usually in clinical negligence claims, and on medical records in family and other cases. It needs training in report writing and the court's rules, and many experts take a course before their first instruction.

Pay. When legal aid pays, the rate is set in regulations and has not changed since December 2013:

• a GP expert: £79.20 an hour outside London, £72 an hour in London
• a GP records report: a fixed fee of £50.40 outside London, £72 in London

Work instructed privately, such as most clinical negligence claims, is priced by the expert and pays more, but there is no official figure for it.

Writing and media

Medical writing covers a wide range: patient information, continuing education, articles for the GP press, and regulatory and promotional work for the pharmaceutical industry. The European Medical Writers Association's 2023 survey of 223 freelance writers, mostly in Europe, found a median of €82.20 an hour across all types of work, rising with experience.

Writing for GP publications is paid per article, at rates the publication sets. Pharmaceutical work pays well but brings conflict-of-interest declarations with it, and the GMC's guidance on conflicts of interest applies to everything you write.

Leadership

• PCN clinical director. Since 2025/26 there is no separate clinical director payment: it is part of the core PCN funding, and each PCN decides how much time and money its clinical director gets.
• ICB clinical leads and LMC officers. Paid sessionally at rates the ICB or LMC sets, usually advertised with the post.
• Appraisal leads, associate deans and senior educator roles. The next step for many trainers and appraisers, advertised by NHS England's regional teams.

Clinical work outside the practice

Some of the most common additions are still clinical, just somewhere other than a surgery. Pay for these is set by each employer, and none has a published national rate.

• GP with an extended role, in dermatology, musculoskeletal medicine, gynaecology or another area, under the RCGP's framework, usually with a recognised qualification.
• Out of hours, urgent care and NHS 111. Sessional work, employed or self-employed depending on the provider.
• Prison healthcare, police custody and sexual assault referral centres, with training from the Faculty of Forensic and Legal Medicine for the forensic roles.
• Occupational health, where a Diploma in Occupational Medicine is the usual starting point.
• Event and expedition medicine, from sports events to remote travel.
• Private general practice, either alongside NHS work or as a separate service.

What extra roles change for tax, pension and indemnity

How you are paid decides how you are taxed. Some roles come through a payroll with tax already taken off, as NHS trust bank work and casual-worker roles usually do. Others are fees you invoice, which are self-employed income on your Self Assessment return, with any allowable expenses taken off. Several small self-employed incomes added together count towards the Making Tax Digital threshold.

Only some of it builds NHS pension. Appraisal and other self-employed work for NHS bodies can be pensionable practitioner income, declared on your Type 2 form. Fees from a university, the RCGP, a law firm or a publisher are not NHS practitioner income, so they build no NHS pension. Extra pensionable work also adds to your pension growth for the annual allowance.

Through a limited company. Invoicing a public body such as NHS England, the CQC or a university through your own company puts the decision on IR35 with that body. The sole trader vs limited company guide explains what that means.

Indemnity. Medico-legal reports, expert evidence and some advisory work may not be covered by the indemnity for your clinical work. Tell your defence organisation what the new role involves before you start it.

Frequently asked questions

How much are GP appraisers paid?

NHS England pays a fee per appraisal. An NHS England Midlands advert in 2023 offered £584 per appraisal plus pension contributions where the appraiser is pensionable. Fees are set by NHS England, so check the current figure with your local appraisal team.

Do GP trainers get paid personally?

The trainer grant is paid to the practice, not to the trainer, at £10,796.91 a year for each GP specialty trainee on the 2025/26 rate. How much of it reaches the trainer depends on the practice: a partner shares in it through the practice's profits, and a salaried trainer's share is a matter for their contract.

Is income from extra roles NHS pensionable?

Some of it. Appraisal and other work for NHS bodies done as a self-employed practitioner can be pensionable and is declared on the Type 2 form. Sessional fees from a university, the RCGP, a law firm or a publisher are not NHS practitioner income, so they build no NHS pension.

Do I need extra indemnity for non-clinical work?

Often. Medico-legal reports, expert witness work and some advisory roles may not be covered by the indemnity for your clinical work. Check with your medical defence organisation before you start, and tell them what the work involves.

How is the income from extra roles taxed?

Pay that comes through a payroll has tax taken off before you receive it. Fees you invoice are self-employed income, declared on your Self Assessment return, with any allowable expenses taken off. Several small self-employed incomes added together also count towards the Making Tax Digital threshold.

Sources

Checked 3 October 2026. Figures from job adverts are examples of what one employer offered on the date shown, not a national rate.

• GP trainer grant: £10,796.91 a year from 1 April 2025 (£899.74 a month), CPD allowance and foundation grant, as published on deanery practice payment pages, including NHS England East of England and the West Midlands
• GP Training Programme Director, Leeds, NHS England, posted 30 September 2024: £114,101 a year pro rata
• General practice teaching opportunities, University of Glasgow: teaching and OSCE examining rates. The University of Manchester figure is from our own experience of examining there, not a published rate.
• Becoming an examiner and Update on fees for the SCA examination, RCGP: requirements, recruitment, and examiners paid for time out of practice
• GP Medical Appraiser, Midlands, NHS England, listed 12 September 2023: £584 per appraisal plus superannuation if applicable
• CQC Specialist Advisor, General Practice: £540 a day including annual leave entitlement, as advertised on job boards in 2026; background on the role on CQC's information for specialist advisors
• GP Medical Examiner, Milton Keynes University Hospital NHS Foundation Trust, posted 30 September 2024: £75 an hour
• Pay scales for consultants in England, BMA, updated 14 August 2026: £113,565 to £150,569
• Guidance on the remuneration of expert witnesses in family cases, Legal Aid Agency, June 2026, and Schedule 5 of the Civil Legal Aid (Remuneration) Regulations 2013: GP rates on cases started on or after 2 December 2013
• Seventh Freelance Business Survey, European Medical Writers Association, 2023: a median of €82.20 an hour
• Network Contract DES specification 2025/26, NHS England: clinical director funding merged into core PCN funding

A note on advice

This guide is general information, not careers, tax or financial advice, and the figures in it describe what has been published or advertised, not what any role should pay. Rates change every year: check the current figure with the organisation offering the role before you rely on it.