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At the heart of general practice since 1960

GPs face stark enhanced services inequity

By Nigel Praities

GPs around the country are receiving hugely varying amounts of enhanced-service funding, with an 18-fold difference between the most and least generous PCTs.

Pulse's figures – taken from 101 trusts – make a mockery of attempts to match the level of need with funding through the global sum. The average enhanced-service funding of £14.59 per patient conceals a huge gap between winners and losers, which more than cancels out global sum weightings through the Carr-Hill formula.

The figures reveal spending on enhanced services has risen overall by a fifth in three years, to an average of £9.4m per PCT this year, but not in all areas.

NHS East Sussex Downs and Weald pays the most of all PCTs, with a projected spend for 2009/10 of £24.29 per head of population. In contrast, NHS Telford and Wrekin pays the least, with a projected spend of just £1.35 per head.

The results undermine Government claims that GPs are able to make up for pay freezes by offering new enhanced services, with that option apparently closed to many practices.

Dr Mary McCarthy, LMC chair for Shropshire, said the figures were a ‘surprise'. She said she would approach NHS Telford and Wrekin for an explanation: ‘It may be the take-up is less. Shropshire is in a worse financial state than Telford and it may be because Telford are not paying out as much for enhanced services.'

An earlier Pulse survey of 22 PCTs found 55% were planning to put the brakes on enhanced-service funding next year.

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