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NHS England 'underspends' primary care budget by £163m

NHS England may have underspent £163m on primary care last year, which has now been likely lost to the health service, accountants have warned. 

A finance report from NHS England shows that budgeted spend on 'primary care and secondary dental' was £10.395bn in 2015/16, but only £10.232bn was actually spent.

It showed this left an underspend of £162.7m, or 1.6% of the total budget.

NHS England has refused to explain the figures, or outline what happens to the unspent money, despite repeated requests from Pulse.

But accountants have told Pulse it most likely goes back into the Treasury's coffers to plug gaps elsewhere in the Government's budget.

Medical accountant Bob Senior, head of medical services at RSM and chairman of Aisma (The Association of Independent Specialist Medical Accountants), said: 'The report does indeed show an overall underspend on primary care of £163m.'

But he added that 'perhaps the most interesting point in the document' was the fact that 62 CCGs reported underspends totalling £122m against their annual plan.

He said: 'Given the pressures that primary care is under I would have thought that they should have ensured that they spent the money on services rather than allowing it to remain in reserves.'

The finance report showed that in all, NHS England underspent some £600m last year. Asked what would happen to the money, Mr Senior said he thinks it gets handed back to the Treasury.

'I am not certain what happens to the overall underspend of £599.4m but given the way government accounting works I rather suspect that it simply disappears back into the Treasury’s coffers to help reduce the overall public sector deficit.'

The Treasury did not respond to Pulse in time for publication.

GPC deputy chair Dr Richard Vautrey said: 'Whatever the figure in a balance sheet, the reality is that general practice was significantly underfunded in the last year and we not only need every possible penny budgeted by the NHS for general practice to be spent on general practice, we also need to see a major additional investment to turn around the current crisis.'

This comes as GPC chair Dr Chaand Nagpaul warned that underfunding of general practice had plunged it into 'new depth' last week, calling on the Government to increase the size of the entire NHS budget to a larger share of GDP.

But in response to the call, health secretary Jeremy Hunt pointed to the investment pledges in the GP Forward View and defended economic austerity.

Readers' comments (3)

  • Mr Senior, CCG's are under strict instruction from NHSE to achieve a surplus which is kept as a reserve and cannot be spent. Don't ask me why.

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  • Perhaps any "underspend" could be redistributed to CCGs which have "overspent" as a result of the seemingly random budget allocations to different areas, thus correcting the over and under budgets.

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  • The underspend lines the pockets of NHSE cronies and partner under various pretexts. OOH contracts of the tune of 1.2 million were given in the southeast to a group of practices with an LMC member. There was no information anywhere and some Practices are not even sent emails.
    In another negotiation regarding closure of a Practice, when at the table it turned out that 'sharing the loot' while dispersing the 7000 strong population could be challenged - a resolution was reached but the Practices who participated in the initial meeting were not informed in what the resolution was. This is where suggestions of outright corruption and deal making kick in. We need NHS Fraud to look into things like that. Or is the present government impotent (they are going through a depressive phase for sure but arrogance and disregard for the deprived resulted in worse things in French history on our neighbours' example)to control NHSE?

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