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Independents' Day

Commissioning leaders call for general practice to receive 10% of NHS funding

Commissioning leaders have called on the Government to increase primary care funding to 10% of the total NHS budget, from the estimated 7.5% share currently given.

The NHS Alliance report published this week – Think Big, Act Now: Creating a Community of Care – said that additional funding and support is needed if primary care is to develop successfully ‘at scale’.

The group has called for the introduction of a ‘General Practice Development Fund’ – funding above the 10% share of the total NHS budget it recommends – to be administered by CCGs and used to ‘kick-start’ the process of transformation, which it says will involve GP practices working together to survive.

The report estimated that the ‘general practice share of the NHS budget has reduced from 10% to 7.5% between 2005/06 and 2012/13’, despite its estimate that ‘approximately 80% of all contact with health services in the UK involves primary care’.

It added: ‘We believe it needs to return to its previous 10% within the next three years, during which time a new financial model can be developed which works across primary and secondary care.’

Dr Mike Dixon, chair of NHS Alliance, told Pulse that the money in the General Practice Development Fund would be in addition to the 10% of total NHS funding allocated in general practice, and should be made accessible to clinicians in all arenas of primary care, including community pharmacists and third-sector organisations.

He said: ‘You can’t do all the things we need primary care to do unless you invest: you have to invest to save. We needs funds and support from CCGs: it means more money going into primary care, but we know primary care is the answer to hospital care so it makes sense.’

In addition to highlighting the need for more funding, the report’s authors called for a ‘fundamental shift in thinking… by all who interact with the health service’.

The report said that primary care clinicians should be willing to consider ‘radical’ ways of funding extended primary care that would ‘enable practices to work together, for instance as co-operatives or integrated care organisations’.

The group also wants to address the ‘medicalisation’ of social issues often encountered by GPs by reinstating traditional senior community nursing roles and creating new ‘community healthcare connectors’ – GPs or nurses whose role it would be to take responsibility for local healthcare over populations of 30,000 to 70,000 people.

Dr Dixon said that while he accepted the measures would need substantial resourcing, such investment was necessary if morale was to be restored in general practice.

He added: ‘General practice is currently working 14-hour days and generally feeling battered and not respected. But if practices were to work together, with populations of 50-100k, primary care could actually begin to do some fairly dramatic things in terms of improving local health.

‘We can get out of this mess, but we do need a bit of support to do so.’

Readers' comments (11)

  • The wheel is a lovely invention the only thing is it goes round and round and always comes back to the same position over time

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  • Need to bring in co payments and an insurance backed scheme (like everyone else in the world does). Otherwise, can the last person to leave turn out the light?

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  • He is talking complete sense, can we have 10% of the buget please? - completly reasonable.

    Will it happen? ...likly not - the NHS is not arranged on principles of reasonableness and sense.

    Lord Dazi, for example, wants 4% of the entired NHS buget just for London primary care - this guy has form and a great big article was written here in PULSE about it and the report was published in full. That to me is nonsense - but got more coverage.

    It is how the NHS and the country more widly is run. More often than not its not about sense, its about nonsense.

    Sounds defeatist perhaps - but I've no confidence that any of the current political parties have any idea about how primary care should be arranged and funded. Hence the existance of people like Lord Darzi and the entilrly probably out come that this sensible mans proposals will fall on deaf ears.

    NHS England is run by a man who was until recently running the European arm of an American private health care company. Thats the way general practice is heading - large scale private companies american style.

    Noone has been consulted, but it will happen anyway. Anyone sensible would realize that working as a GP in the UK means an uncertain future which will probably be salaried, 24/7, run by big corporations Dr light and nurse heavy with little continuity of care, even higher indemnity insurance as a result, and be equally bad for Drs and patients alike - its heading down the American route - thats where we'll be in 10 years.

    If you are considering becoming a GP - dont

    There's a work force crisis for a reason. Medical students are sensible, and so are those retiring early and the ones who've gone prematurely locum - you cant spend hour after hour every day coming up with solutions to the every day problems that face every level of society and not have a modicum of sense about you - unlike the people who make the decisions on funding in primary care - they don't have to be sensible to be in their job - and consitently - they are not.

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  • I am in tears here.
    Can't face the thought of another 25 years of this
    I am a 40 year old gp partner. I love the job of seeing patients but can't see how things will improve.
    I am exhausted with 14 hour days. Bringing paperwork home every Saturday and Sunday. My patients think I am grossly overpaid and this demand culture means that I am constantly told 40 patient face to face consultations 15 to 20 calls, 3 to 5 visits each a day and reams of scripts ,bloods,hospital letters DLA ESA and private reports. My kids never see much of me. I feel something is very broken. I Have never felt this destroyed before. I will resign soon I think , but just heartbroken that it has come to this.

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  • @3.27. Don't dispair, be proactive. I felt the same way as you 4 years ago and decided to leave the UK. My wife and my teenage children were supportive and now none of us would return to the UK under any circumstances. Do some research, find out where you would be happy working and do the move. What is the worst that can happen? All the best. Ex pat GP

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  • @3.27.
    You should not be doing this much work, there is no need to ruin your life in this way.
    Not all practices are like this.
    Do fewer sessions, delegate more, don't do any unnecessary work, or find another practice.

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  • Took Early Retirement

    3.27. Sorry to hear this. Might be better as a sessional GP till you can emigrate?

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  • 3:27

    Am with all of the above. Take matters into your own hands- it sounds scary to consider the alternatives but getting a work life balance and learning to live with reduced income perhaps from what you have, may in many ways allows you to consider an alternative happier/simpler life that you and your family will benefit from.

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  • Publicity stunt by the NAPC, an organisation with no mandate to represent primary care, who were seduced by Lansley into a photoshoot at Downing Street supporting the unholy mess we have now.

    Need to do more to gain credibility than this.

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  • Completely agree with NHS Manager. Dixon and Co supported and campaigned for the Lansley "reforms". They knew better than the overwhelming majority of the medical profession, the Royal Colleges, the BMA, nurses,allied professions etc.who all opposed the disastrous NHS Bill.Result: chaos, breakup of clinical linkages,crazy competition rules favouring private companies and a totally demoralised GP workforce, Billions of pounds have wasted on this disastrous reorganisation exercise.When will these unelected spokespersons (NAPC,Alessi,Dixon,Charleson etc} get the message?

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