A 24/7 GP service and private medical insurance look like the same benefit on a brochure. They are not.
Both sit in the "health" column of a UK SME's benefits stack. Both make staff feel looked after. But they cost different orders of magnitude, they're taxed differently, and they solve different problems. Pick the wrong one and you spend ten times what you needed to — or you buy fast GP triage when what your team actually needed was funded knee surgery.
GP access is the harder of the two issues to argue with. NHS Digital recorded 32.0 million GP appointments in England in April 2026, with 44.6% taking place on the same day they were booked — meaning the majority did not. NHS England's 2025/26 operational planning guidance asks Integrated Care Boards to "continue to support general practice to enable patients to access appointments in a more timely way". Demand is real. So is the funding gap.
This guide is for the UK SME founder, HR lead, or finance lead deciding which lever to pull — or whether to pull both.
What each one actually does
The two products look alike from a distance, but the mechanics underneath are different.
A 24/7 GP service
A workplace 24/7 GP service gives every covered employee on-demand video or phone consultations with a UK GP, typically inside 30 minutes. The doctor takes a history, makes a working diagnosis, issues a private prescription, writes a referral letter where needed, and signposts to NHS pathways or a PMI policy if one exists.
The non-negotiable quality bar is GMC registration. The General Medical Council holds the statutory register for all UK doctors; a GP on the GMC GP Register has completed UK general practice training and holds a licence to practise. Any provider that won't confirm 100% GMC-registered, UK-licensed clinicians on the video call should be ruled out.
What a 24/7 GP service does not cover: hospital admissions, consultant appointments outside basic referral, diagnostic scans, or surgery. It is a front door, not a treatment fund.
Private medical insurance (PMI)
PMI is an indemnity insurance product. The employer (or the employee) pays a premium; the insurer pays for acute private treatment within the policy terms. That typically covers consultant outpatient appointments, diagnostic scans (MRI, CT, ultrasound), inpatient stays, day-case surgery, and some specified mental-health treatment. Most policies have an excess, exclusions for pre-existing conditions, and annual limits on certain categories.
The Association of British Insurers reports that UK insurers paid out a record £4 billion in individual and workplace PMI claims in 2024, up 13% on the £3.57 billion paid in 2023. That tells you two things: demand for private treatment is climbing fast, and the average claim size is rising with it.
What PMI does not usually cover: GP appointments. A handful of premium-tier policies bundle a "virtual GP" service in, but the core PMI product assumes you already have a GP. The two products are complementary, not substitutes.
The cost gap, sourced
This is where the decision sharpens. The two benefits sit on different price floors by an order of magnitude.
PMI premiums vary widely by age, region, claims history, excess, and chosen hospital network — which is why this guide will not invent a single "average PMI cost". The honest direction of travel: PMI for a working-age SME workforce is typically priced in the hundreds of pounds per employee per year, climbing into four figures as the team's average age rises. The ABI £4bn claims pool indicates the per-policy spend the market is supporting; insurers publish their own quote ranges on corporate pages. Get a written quote for your specific workforce before committing.
A workplace 24/7 GP service sits in a different bracket. No underwriting, no hospital network, no claims function — so per-head pricing is typically in low double-digit pounds per employee per year, not three or four figures. WagePerks quotes the GP add-on on call because pricing depends on headcount, family-cover inclusion, and expected consult volume; the order of magnitude is consistent across the workplace virtual-GP market.
Run the maths on a 50-person SME:
- A 24/7 GP service in the low-tens per head: roughly £500 to £1,500 a year for the whole workforce.
- PMI at a mid-range workplace premium: easily £15,000 to £40,000+ a year for the same headcount, before any tax loading.
The two are not interchangeable budget lines. They are different decisions. A GP service is a wellbeing benefit you add because GP access is broken. PMI is an insurance line you add because you have decided to insure your workforce against the cost of private acute care.
Tax treatment — the bit nobody mentions
This is the section most brochures skip. The tax position is not the same for both.
PMI is a taxable benefit in kind
Per HMRC guidance on expenses and benefits for medical treatment and insurance, when an employer arranges and pays for medical insurance, the employer must report it on form P11D and pay Class 1A National Insurance on the cash equivalent of the benefit. The employee then pays income tax on the same value through their tax code.
That has two practical effects most SMEs underestimate:
- The headline premium is not the real employer cost. Add Class 1A NIC at the current rate. For a £600 premium that's an additional Class 1A charge on top.
- The employee takes a tax hit on the benefit. A higher-rate taxpayer on a £600 PMI premium effectively loses £240 in extra income tax — a fact many staff only discover when their tax code changes mid-year. Salary-sacrifice PMI arrangements are explicitly excluded from any otherwise-exempt treatment, per HMRC's "what's exempt" guidance.
A 24/7 GP service is more nuanced
HMRC's general principle is that one health screening or medical check-up per employee per year is exempt from tax and NIC, alongside specific carve-outs for eye tests for screen workers, flu vaccinations, work-related injury treatment, and up to £500 of rehabilitation costs. A general-purpose 24/7 GP triage service does not slot neatly into those exemptions, so assume employer-paid GP services may need to be reported on P11D — but the cash equivalent is dramatically smaller because the underlying cost per head is dramatically smaller.
Practical rule for finance leads: treat both as reportable benefits in kind for budgeting, then get written confirmation from your accountant on the specific product before year-end. The order-of-magnitude difference in premium drives an order-of-magnitude difference in employer NIC and employee tax.
When PMI is the right answer
PMI earns its premium when three conditions hold:
- Your team skews older, or your sector carries a higher risk of musculoskeletal injury, cardiovascular conditions, or any other category that lands on a consultant's waiting list.
- The cost of waiting — for the business, not just the individual — is high. A senior salesperson sitting on an 18-month NHS waiting list for elective surgery is a different commercial problem to a junior team member needing a routine GP appointment.
- The business can afford four-figure-per-head premiums without compromising other benefits.
Senior leadership teams in growth-stage businesses are the classic PMI cohort. So are partnerships, professional services firms, and any business where the cost of a key person being out of action for nine months dwarfs the annual premium.
When 24/7 GP wins
A 24/7 GP service is the right answer when:
- Your team is broadly healthy and skews under 45. The marginal value of insuring against private treatment is low; the value of seeing a GP at 9pm on a Tuesday is high.
- Your pain point is access, not treatment funding. Staff need someone to look at the rash, the lingering cough, the anxiety symptoms — and a same-day NHS slot is not available.
- You want a benefit every member of staff actually uses. PMI utilisation concentrates in a small percentage of policyholders; a virtual GP service gets used much more widely because the threshold for "I'll ring the GP" is low.
- You are budget-constrained. At a tenth of the per-head cost, a GP service is the easier SME business case.
For most UK SMEs under 100 staff with a working-age workforce, a 24/7 GP service delivers more visible employee impact per pound than PMI.
The "both" option
The two products layer well, and increasingly this is what mid-market employers do.
The pattern: a 24/7 GP service for the whole workforce, plus PMI for the senior team or a specified cohort (e.g. all staff above a salary band, or in roles where downtime is costliest). The GP service handles universal access cheaply. PMI handles treatment funding for the cohort where the maths works.
This also justifies cleanly to a finance committee. The GP line is a small wellbeing investment with broad reach. The PMI line is a targeted insurance product tied to specific roles. Separate budget lines, reviewed independently.
How WagePerks ties in
WagePerks is a UK HR, payroll, and benefits platform at £4.50 per employee per month, all-in, eleven modules, white-label included, rolling monthly. The base covers HR, payroll, absence, clock-in, payslips, document management, onboarding, recognition, shift/rota, the employee marketplace, and the white-label app. Full feature parity in any modern browser; native iOS and Android apps launching Q3 2026.
The 24/7 GP service is an optional add-on, quoted on call, using 100% GMC-registered UK GPs by video or phone, 24/7, 365 days a year. The Employee Assistance Programme is a separate optional add-on, also quoted on call, with BACP-registered counsellors and EAPA UK-aligned five-component coverage.
The GP service feature page walks through the in-platform view. The 24/7 GP service explainer covers the clinical model, GMC checks, and prescription pathway. The Employee Assistance Programme feature page covers the EAP. For the wider stack, see the employee benefits overview or the EAP buying guide.
Neither the GP service nor the EAP replaces PMI. If your team needs funded consultant care or surgery cover, get a PMI quote from a regulated insurer. If your team needs to see a GP at 11pm on a Sunday, that's what the add-on is for.
Sources
- NHS Digital — Appointments in General Practice, April 2026 — 32.0 million appointments, 44.6% same-day.
- NHS England — 2025/26 Priorities and Operational Planning Guidance — GP access expectations for ICBs.
- ABI — Health Insurance guidance — £4 billion in PMI claims paid in 2024, +13% on 2023.
- GOV.UK — Expenses and benefits: medical treatment — overarching employer reporting obligations.
- GOV.UK — Medical treatment: what's exempt — limited exemptions for health screening, eye tests, flu vaccinations, work-related treatment, and rehabilitation.
- GOV.UK — Medical treatment: what to report and pay — P11D reporting and Class 1A NIC on employer-arranged medical insurance.
- GMC — Registration and licensing — UK doctor register and licence to practise.
- CIPD — Health and Wellbeing at Work 2025 — 9.4 average sickness days per employee per year, highest in 15+ years.
Sources verified 2026-06-10. We re-verify quarterly.