Between 2011 and 2012, our figures show that the average ENT consultant increased his or her gross income from private practice by about 3% from £128,000 to £132,000. They have broadly kept up with inflation!

Costs have shown a modest increase of 2%, rising from £52,000 to £53,000.

As a result, taxable profits have increased, on average by 4% from £76,000 to £79,000.

As we have noted previously, it is becoming increasingly difficult to make genuine comparisons between individuals in this specialty.

Some ENT consultants have embraced the concept of groups, and this has impacted on incomes.

Fuller service

Others have chosen to increase diagnostic and other equipment and to provide a fuller service than the traditional ENT consultant.

While our analysis is not statistically valid, it is rather an overview of what a typical consultant working in the NHS and with a private practice might expect to earn and what expenses they might expect to incur.

One of the problems of ‘averages’ is that they are biased upwards by performances of very high earners.

Our average figures differ from median figures and are, of course, biased towards London and the South-east.

The impact of NHS Choose and Book work is having a significant effect on ENT surgeons’ private practice incomes across the country.

Market analysts LaingBuisson in its Healthcare Market Review estimates that NHS work now accounts for in excess of 25% of the private practice market.

Such a dramatic increase has helped to offset pressures on incomes as a result of various insurance company squeezes. This trend is likely to continue as the NHS share of the market increases.

Costs for most ENT surgeons have shown little change between 2011 and 2012.

Cost increases

There has been some increase in employment costs from £14,000 to £16,000 on average. Our view is that where family members are employed, salaries have shown some increase, no doubt stimulated by the increase in personal allowances over recent years.

There has been a modest rise in consulting room fees. We expect this to increase further as the full effect of the Competition and Markets Authority’s recent rulings are implemented.

At least professional indemnity costs seem to have stabilised – though our figures have been influenced by some members seeking cheaper cover elsewhere.

There has been some fall in motor expense costs, doubtless influenced by publicity in Independent Practitioner Today relating to mileage expense rules.

Perhaps surprisingly, there has been some drop in ‘other expenses’ primarily relating to marketing costs.

There was a flurry of activity some years ago as ENT consultants worked on establishing their websites. Some of these costs were of a one-off nature.

The overall picture for ENT surgeons now therefore seems to be one of stability – with an increase in NHS-derived work offsetting pressures on fees from insurance companies.

We do expect to see some increase in costs in future years, but the overall situation seems promising. The market also seems to have bottomed out and is showing some signs of recovery.

Ray Stanbridge runs an accountancy, finance and tax advisory service specialising in the medical profession. Martin Murray is a partner at Sandison Easson & Co, specialist medical accountants