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A faulty production line

GPs missing out on millions from developers 'due to CCG confusion'

The NHS is missing out on millions of pounds from property developers that should be used to help services like GPs cope with extra demand, a report by think tank Reform has found.

The review found that section 106 funding, collected from housing developers by local councils and then given to health commissioners, is not being passed on to practices because in some cases CCGs do not always have a clear understanding of how it should be spent.

In addition, the report noted CCG requests for the money have been challenged by councils that argue the money is going to 'a private or commercial enterprise'.

NHS England and CCGs should complete an appraisal of the different GP ownership models that would ‘best satisfy the planning requirements’ of councils to ensure more money reaches general practice, said the report.

The BMA said the report highlighted it was 'essential' that routes to accessing the money were made clearer.

The report found only 36% of local councils had secured section 106 funding - which can be used for the NHS or other public services - to spend on healthcare between 2013/14 and 2018/19.

Data obtained through freedom of information responses showed 105 local planning teams, out of the 293 responding, had altogether collected £87m for healthcare.

But even then, around half of the money - £41m - was being held by planning teams and had not yet been transferred to the healthcare provider.

As of 2018/19, a total of 20 local planning teams still had more than £500,000 of section 106 funds waiting to be transferred to the NHS. In one case, Exeter City Council was still holding more than £10m.

The think tank did not explicitly ask local authorities if they had collected developer funding for healthcare projects through the community infrastructure levy instead, but it said only 29 local planning teams had indicated this as a possibility.

The report noted GPs rely more on the cash than hospitals because they receive less funding from central Government.

But CCG requests for the money to be used on practices are sometimes questioned by local councils due to the belief that this would equate to spending the cash on a 'private or commercial enterprise'.

The changing requirements and priorities within the NHS also mean local councils view healthcare projects as riskier - because there is less certainty projects will be delivered on time, said the report.

The report added: 'NHS trusts and CCGs do not always have a clear understanding of how they should spend section 106 funds or utilise in-kind contributions.

'There is often no clear remit for dealing with section 106-related issues at the trust or CCG level, meaning that the estate needs of each area are not fully understood, therefore delaying decisions around the spending of section 106 monies.'

The report called for CCGs, NHS England and NHS Improvement to complete an appraisal of the different GP ownership models so they can understand more clearly how this tallies with local council planning requirements.

Claudia Martinez, lead author of the report and research manager for Reform, said: ‘The NHS estate is in dire straits and yet millions are being left unspent or untapped.

‘Given the scale of the Government’s house building ambitions and the pressure it will put on local services, it must urgently act to rectify this.'

Commenting, Dr Chaand Nagpaul, BMA council chair, said: 'NHS infrastructure is in dire need of investment both in primary and secondary care and this is adversely impacting on patient services.

'It’s essential that there is greater awareness and clearer pathways so that this vital money is made more accessible to enable doctors and staff to work in fit for purpose buildings that meet patient’s needs.

An NHS England spokesperson said: 'The NHS long-term plan will mean £4.5 billion extra each year for primary care, but as well as additional national investment, making sure appropriate local funding is made available for an area’s health services is a value for money investment, which allows the NHS to offer the best possible care for patients.

'We expect councils, GPs and other services in the community to work together to get funding into people’s essential health care services.'

Readers' comments (5)

  • “section 106 funding, collected from housing developers by local councils and then given to health commissioners, is not being passed on to practices because in some cases CCGs do not always have a clear understanding of how it should be spent.“

    Socialism for you. The art of not knowing how to best spend other people’s money (not very surprising is it when you never earned the money yourself) which inevitably leads to squander and waste

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  • So true Harry. It is so easy to take other's money and spend it on meaningless things, gamble it or giving themselves a pay rise.
    "We know how best to spend the money, you've earned".
    The collection is not done properly and not being passed on. Any accountability? Guess not.

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  • We have been asking re 106 monies for years from our CCG/ council and have never received a penny always told they have been spent elsewhere.

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  • National Hopeless Service

    There is no confusion. Developers have a contract with the district/borough council setting out clearly what Section 106 monies are for what. The confusion is that CCGs are hell bent on micro-managing GP to the point of obstruction. Unspent monies are given back to the developers after ten years.

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  • Contributing to local infrastructure like Health, Public Transport, Amenities etc when you are planning to cover the locality in new housing and making a big profit from that sounds like a good concept to me, shouting socialism and snorting misses the point.
    Section 106 is a difficult system to process for CCGs and NHSE because of the convoluted funding streams Primary Care receives. They often conflate it with Practice Development funding, which it isn't.
    We found out about planned developments in our patch and actively engaged with developers who were happy to contribute via 106 and specified with the local authorities that contributions should be specifically spent for our practice. It was the CCG and NHSE who wouldn't engage in first accepting and then releasing the funds for those specified improvements at our surgery for nearly 9 years but we succeeded in the end.
    I would recommend to engage with developers directly despite being discouraged by CCG/NHSE from doing so. They claim they have their own teams raising 106 issues but they are so woefully underfunded/-staffed/ignorant as to be near non-existent hence above article.
    Then make sure developers specify the recipient and the purpose in broad terms ("50K£ for practice X to increase consulting space"). This is vital, otherwise the money disappears in a black hole.
    Then speak to and engage your local councillors and get them on your side. They will hold the moneys for 5 years until the project gets started.

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