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More funds seep away

A skeleton came rattling out of primary care's closet this week, as a Pulse survey revealed as many as a sixth of trusts have quietly abandoned their enhanced service floors. In total, half of all PCTs underspent on enhanced services last year, and already many are expecting to do so again this year.

Sadly, where once the loss of enhanced service cash provoked a furious reaction from GPs, now it merits little more than a weary shrug of resignation. And where once ministers promised to clamp down fearsomely on trusts that refused to pay up, now they are happy to play the Pontius Pilate, wash their hands and walk away.

Writing on the wall

The writing has been on the wall for enhanced services for some time now. Since January 2006, in fact, when the Department of Health shelved the requirement for a funding floor – downgrading it to the status of 'indicative monitoring level'. PCTs saw that as giving them carte blanche to do what they liked with the cash, which too often has meant pouring it liberally down a gaping hole marked 'deficits'.

But with pensions caps, pay freezes and countless other assaults on practice income, GPs cannot afford to let their enhanced service funding seep away without a fight. Indeed, with the Government's drive to shift care into the community gathering pace, cash for extra GP services is going to become more important than ever. Surely it is time to ramp pressure back up on PCTs, to force them to cough up the promised cash.

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