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Independents' Day

Networks will 'struggle' to find 30% of funding for extra clinical roles

Primary care networks in some regions of England will struggle to find the money they are expected to contribute towards hiring additional clinical staff under the new DES agreement, GPs and academics have warned.

Under the new network DES arrangements, NHS England funding will be unlocked to employ 22,000 additional practice staff – including pharmacists, physiotherapists, paramedics, physicians and social prescribing workers – by 2023/24.

NHS England has guaranteed to cover 70% of the costs for pharmacists, physiotherapists, paramedics and physicians and 100% for social prescribers.

But GPs and policy leaders have argued some networks - particularly those in deprived areas, where funding can already be insufficient - may be unable to provide the remaining 30% of costs for some of the roles.

Speaking at a King's Fund event on PCNs this month, the think tank's senior policy fellow, Beccy Baird, suggested the Carr-Hill Formula, used to reflect factors that influence patient needs and costs, may be to blame.

She said: 'I think that for some areas in the country the finances are great but will still be challenging.

'We know that there are already issues around the Carr-Hill formula, which is how a lot of the contracts work, as it doesn’t necessarily reflect deprivation in the way that it might. There’s a little bit of a worry that the money might not reflect the needs out there.

'There are networks where actually [finding] 30% of the funding for the new roles will be a challenge, [especially those] that are stressed, have got particular issues going on and are in very deprived areas and already struggling with paying really high locum costs because they can’t attract GPs.'

Echoing her comments, a Londonwide LMCs spokesperson said: 'Whilst the additional staffing support provided for within the network contract DES is welcome, we know that at a time of massive workload and workforce pressures some practices will struggle to find the necessary funds to cover additional salary costs as they juggle the demands of their existing practice teams and meet patient demand.'

Farzana Hussain, a GP in London who has also been appointed as a PCN clinical director, said the new roles - particularly those taking on advanced clinical tasks  - would require a 'clear job description and training' that would be costly.

She said: 'In my network we want the pharmacist to play a key role in the new network-based quality improvement QOF indicator for high-risk medications. We want them to do medicines reconciliation from hospital letters and undertake long-term condition reviews with prescribing. 

'A clear job description and training for pharmacists is essential. This will need initial investment and extra money, which some practices will struggle with due to high GP locum costs, for example.'

A recent report by the Health Foundation found that networks were 'rushed' and implemented at a 'very difficult time' when GP practices have limited resources to spare.

Meanwhile, Pulse reported earlier this month that commissioners' plans to hire PCN deputy clinical directors in the East Midlands - to work alongside clinical directors and support the development of networks - will exacerbate workload.



Readers' comments (5)

  • We're not going to let a physicians assistant step foot in our surgery so there's some money we won't need to find.

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  • Clearly Fake News as the BMA negotiators have repeatedly told us how the new Contract was wonderful and would make everything better.

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  • Nice one BMA. No money leads to no staff, leading to no more appointments and same old stress leading to back in the same old shit again.

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  • told you so. only way to fund it is to lose a GP or two. its all thought out you know. we are in the end game before privatisation. watch primary care burn. next will be merging practices and first line contact with be noctors only with a GP to supervise, then GP management roles will be taken by non medical managers, GPs will become subsidiary on employed contracts, CCGs will plead bankruptcy, private company steps in to save the day, services will be cut, patients will have to pay and then eventually the government have to sort it out, it all goes on social insurance and then topped up by private insurance, employers will be encouraged to take out health insurance for employees and then we are all on private health insurance. God bless america. here we come.

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  • what a crock of poo

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