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At the heart of general practice since 1960

Public health gains in danger as councils cut GP funding

Sexual health, smoking cessation and health checks downsized as a result of government cuts. Caroline Price and Carolyn Wickware report

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The Government promised that its £200m cuts to public health services will not affect frontline services – but a Pulse investigation has revealed that local councils are already making cutbacks to essential services.

These include those run by GP practices, such as contraceptive and sexual health services and NHS Health Checks, and facilities that GPs rely on for patient referrals, like smoking cessation.

One council – York City – has made cuts across the board, citing ‘financial constraints’. Other councils are limiting the number of long-acting reversible contraception procedures they will pay practices for.

Meanwhile, a number of councils are completely discontinuing smoking cessation services.

Many of the cuts are as a result of the Government removing funding from local authority budgets.

Chancellor George Osborne announced cuts of £200m last May, meaning the £2.8bn originally earmarked for councils to spend on public health in 2015/16 was cut by 7%. Further public health funding cuts were promised at the autumn spending review, with plans to deliver 4% savings each year for the next five years.

‘Far fewer will quit’

The Treasury told Pulse the £200m figure was based on projected local authority underspends and that the cuts would not affect frontline services. 

But GPs expressed concern at the effect on patients. Londonwide LMCs medical director Dr Tony Grewal warned that moves to limit the contraceptive services undertaken by practices ‘will diminish patient choice, limit access to these forms of contraception and diminish GPs’ professional competency to undertake these procedures’.

Dr Alex Bobak, a GPSI in smoking cessation at Wandsworth Medical Centre, south London, says smoking cessation service cuts mean ‘far fewer people will stop smoking’.

And councils are warning that the situation could get worse, with York City Council writing to local GPs to tell them there are ‘more challenging times ahead with further reductions in the public health budget’.

Smoking cessation

Pulse has learned of six major metropolitan and county councils that are cutting smoking cessation budgets, including Leeds City Council, which announced a cut of £127,000 from its service with ‘more reductions in subsequent years’ likely, due to a £650m shortfall. 

Elsewhere, Manchester City Council closed its smoking cessation service completely in October, while in York, only those with chronic diseases will be able to access smoking cessation services from the end of March.

The London Borough of Harrow has shrunk its service by 7% because of ‘attacks on our funding for crucial services’. Lincolnshire County Council and Salford City Council are cutting services by 50% and 10% respectively claiming more people are quitting through the use of e-cigarettes.Elsewhere, Manchester City Council closed its smoking cessation service completely in October, while in York, only those with chronic diseases will be able to access smoking cessation services from the end of March.

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Sexual health

Pulse has found more than 20 local councils so far that are potentially taking away these services from GP practices.

Family planning experts warn this could cost the NHS billions of pounds in the longer term, and ‘reverse a decade of progress’ on training and access to contraception.

The councils changing their current provision include:

  • A total of 19 London boroughs, which are putting LARC contracts out to tender as part of a new programme, partly due to ‘the continued squeeze on public sector finances’
  • York City Council, which told practices in December it would terminate long-running contracts for chlamydia screening and long-acting reversible contraception (LARC)
  • Devon and Torbay councils, which will only fund practices for six LARC fittings, with the rest paid at a nurse hourly rate.

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doctorstethoscopepatient330x330px suo

Health checks

GP practices in one area are being told their contract to provide NHS Health Checks will be terminated at the end of March as a result of cutbacks to the public health budget.

York City Council said it would continue to offer ‘some elements’ of the NHS Health Checks programme, which forms a key plank of the Government’s drive to prevent ill health and curb spiralling NHS costs that result from lifestyle issues such as poor diet, obesity and smoking.

Dr John Crompton, chair of North Yorkshire LMC, said to ‘suddenly stop offering those locally in practices would be a disaster… they have invested a lot of time and effort in this.’

He added: ‘We’ve found locally we’re picking up a lot of early diabetes and managing it – if that’s lost potentially that population will have worse outcomes.’

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Readers' comments (6)

  • cutting health checks is a good idea, obviously the smoking/sexual health is false economy + short sighted

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  • Let's face it, we all knew this would happen.

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  • Any reduction in sexual health or LARC services is immensely foolish and will cost vastly more in the end.

    Less worried about smoking cessation (commercially available products and will-power an acceptable substitute). Health checks are a waste of time and money (an experiment that failed first time round when we all tried the Oxford protocol twenty five years ago).

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  • Vinci Ho

    You see
    All Ozzy cares is making more cuts ,' I don't care how you ba***ds will do it, just do it.'
    Vital or not vital , does not matter . But of course , it will back fire . One can do without food for a while but still survive . Without water , one will die very soon.........

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  • What a mess
    Some practices earn £500 per patient
    Some £75 like us
    What can they cut when we get £40k pa

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  • Health checks: an evidence-free zone.
    The rest is just a statement of the obvious:don't smoke;don't drink too much;eat less and move more, oh and problably best to have more than a nodding aquaintance with your partner before you exchange bodily fluids.
    We do not need to fund a vast municiple empire to administer common sense.

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