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Gold, incentives and meh

Extra 'named GP' funding in doubt as CCGs struggle to stump up cash

Exclusive Some GPs may not receive the additional £5 per patient funding supposed to support the new contractual responsibility to be a ‘named GP’ - and those that do may have to undertake additional work - a Pulse investigation reveals.

As many as a third of CCGs have yet to decide if they will offer GPs the extra money, which has been promised by NHS England and the health secretary and is due to begin in April, with one CCG admitting it is waiting on uncertain ‘quality premium’ payments before committing to paying GPs.

Among those who are to offer the funding, meanwhile, many have yet to determine what extra work it may be tied to over and above the new named GP duties, with one CCG planning to commission ‘additional services’ and two others in the process of negotiating ‘baseline outcomes’.

LMC leaders warned that CCGs were likely to struggle to find additional cash to fund GPs’ new duties.

It is a new contractual requirement that practices in England ensure that from April there is a named, accountable GP assigned to every patient aged 75 years and over, with the GP responsible for coordinating and overseeing that patient’s care.

In its ‘Everyone Counts’ guidance, NHS England instructed CCGs to ‘support practices in transforming the care of patients aged 75 or older and reducing avoidable admissions by providing funding for practice plans to do so’. It said this funding ‘should be at around £5 per head of population for each practice, which broadly equates to £50 for patients aged 75 and over’, and said GPs could propose this funding pay for new general practice services or be invested in other community services such as district nursing or emergency response nursing teams.

In an interview with Pulse last month, health secretary Jeremy Hunt also explicitly promised the extra funding would be used to support the new ‘named GP’ responsibility.

He said: ‘It’s a very big change, and there’s a lot of extra work, but that’s why we’ve removed 40% of the QOF targets to help free up GPs’ time, and we’ve also put in extra resources. The extra £5 [per patient funding] is a reflection of the fact that we know that to deliver better care we need more capacity in the system.’

But of the 50 CCGs who responded to an enquiry from Pulse this week, 18 were unable to confirm that they would be able to provide the £5 per patient funding.

One CCG, NHS South Gloucestershire, even admitted it was waiting on whether it would receive the whole ‘quality premium’ funding before committing to the investment.

An NHS South Gloucestershire CCG spokesperson told Pulse: ‘There is no new money in the system to easily fund this requirement. If the CCG achieves the quality premium this will enable us to invest in the fund, which is based on £5 per head of the population.’

In other areas, CCGs were also unable to commit to providing the extra money.

A spokesperson for Cambridgeshire and Peterborough CCG said: ‘We are not in a position to answer questions on this, as the debate about this funding has not been completed.’

A spokesperson for all 12 CCGs in the North East said they were ‘working closely with NHS England to develop their detailed plans for the next financial year, including enhanced services for vulnerable patients and those with complex physical or mental health needs’.

Dr Ken Megson, medical secretary of Gateshead and South Tyneside LMC, predicted CCGs would struggle to find the funding.

He said: ‘There is no new money available. What CCGs will do is take money out of secondary care and slosh it into primary care. It’s not about giving GPs £5 a head to do things differently, but giving services such as district nursing some money to keep people in the community.’

Most of the 32 CCGs who said they would offer GPs an extra £5 per patient said they had yet to decide how the money would be offered. But a number did confirm that it would involve GPs taking on additional work over and above being a ‘named GP’.

A spokesperson for NHS Southampton City CCG said: ‘The funding will be used to commission additional services to support patients in line with our commissioning strategy on behalf of our practices. We are currently in discussions with all of our member practices on how best to invest this funding.’

NHS South Cheshire CCG and NHS Vale Royal CCG said the CCGs had taken an ‘innovative approach’ and were working with GP federations on ‘negotiating baseline outcomes’.

Dr Nigel Watson, chair of Wessex LMCs, said the £5 per patient funding could be used for positive change, but expressed fears that the promised money might not materialise.

He said: ‘There is a real opportunity to embed community nursing services with GP practices and provide integrated services. There could be primary health care teams led by GPs and supported by nurses working in partnership with practices. If you gave GPs £150,000 each and asked them to develop services there could be some imaginative schemes, but at the moment it seems like a lot of talk.’

Readers' comments (44)

  • more lunatic top down micromanagement from an organisation of sick control freaks.

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  • I have spent the day with 3 consultants over the last couple of years and found it really interesting and was impressed with what I saw, finished my VTS in 1987. Each consultant then spent a day in my practices, sitting in consultations, joining in the meetings.
    Each was surprised at what we did in there of quantity and quality as it was very different from the stereotypical view they and their colleagues have.
    Consultant 11.11am you comments are sad and frankly ill informed. We try hard but don't always get it right, we are not perfect but then neither are hospitals or your colleagues.
    I would suggest you do as I have and spend a day with one of your colleagues i.e. a GP and you might be surprised. Happy for you to come to my practice in the New Forest.

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  • We need to work together. The lady rheumatologist maybe has had one too many fibromyalgia referrals. Let's bathe in the breadth of uncertainty and realise all were really here for is to have as good a life as possible for ourselves, our families and our patients. Pass the pen and I'll sign the prescription. Pass the old dear rheumy and I'll give her a hug. Pass the guidelines and ill light my living room fire with them. I love GP land!

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  • Bob Hodges

    Those questions don't just apply to IMGs Una.

    That's the reasons that so many British GPs and doctors are now IMGs in OTHER countries.

    I suspect that India is now now a big enough attraction for Indian doctors, and who can blame them? The faintest hope of an opportunity to spend some of MY career as an IMG in India might improve my morale right now.

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