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GPs buried under trusts' workload dump

PCTs slam brakes on enhanced services funding rise

By Gareth Iacobucci

Exclusive: GPs are facing a sharp slowdown in the growth of their earnings from local enhanced services next year, with more than half of primary care trusts set to slam the brakes on funding.

A Pulse survey of 22 PCTs found investment in LESs will abruptly stall, as trusts try to claw-back savings in a bid to ease the impact of the economic downturn.

Some 55% of trusts revealed they are set to freeze or reduce payments next year, ending several years of rapid growth in LES funding, partly because of the transfer of funds to cover extended hours.

NHS Employers had recommended a gross pay uplift of GPs for this year of just 1.5% of the basis that practices would be receiving a sharp increase in LES funding.

But while Pulse's survey found this year's increase of around £39m was in line with the NHS Employers projections, next year the funding pot is set to increase by only around £6.7m, based on overall investment next year averaging £966,000 per PCT.

Just 45% of trusts are set to increase LES funding next year, compared with the three quarters of trusts who increased payments this year.

It signals an end to three consecutive years of big growth, with overall spend on LESs surging from £104m in 2006/07 to an estimated £224m in 2009/10.

NHS Haringey recently sparked anger among GPs by suspending its LES funding in a attempt to balance the books.

Dr Prit Buttar, head of the GPC finance committee and a GP in Abingdon, Oxfordshire, said it would be difficult for any areas to escape the cuts.

‘In Oxfordshire, they've decommissioned some stuff they've done before and told us they are going to hold a review of all existing enhanced services.'

Dr Buttar predicted PCTs would increasingly look to remove LESs in the hope GPs would continue to do the work regardless.

‘There is a widespread habit of thinking "after a while we can probably stop paying GPs to do it because we can persuade them to do it for free".'

David Stout, head of the PCT Network at the NHS Confederation, said PCTs were ‘duty-bound' to examine all services in light of current financial pressures.

‘I would think they would all be looking at their investments over the next year or two.' But he added: ‘Potentially, this is still a growth area for general practice if they can show what they can offer provides good value.'

The declining growth in LES funding

2006/7 - £104m
2007/8 - £135m
2008/9 - £185m
2009/10 - £224m
2010/11 - £230m

Source: NHS Employers, Pulse survey of 22 PCTs

Some 55% of trusts will freeze or reduce LES payments next year Some 55% of trusts will freeze or reduce LES payments next year

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