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GPs go forth

Plan to rejig GPs' PBC cash

The Department of Health is to commission a new funding formula for practice-based commissioning that will see funds shifted to practices in deprived areas, writes Helen Crump.

The formula is set to revolutionise the way commissioning funds are allocated to GPs because it will work out budgets based on the characteristics of patient lists rather than on historical census data.

Health economists predict that inner city practices could receive a 20 per cent increase in funds at the expense of those in other areas. In the future the formula could form the basis of a revised allocation formula for core practice funding, to iron out some of the inequalities in the global sum formula.

The department is putting the development of the PBC formula out to tender and has set a deadline of 8 March for replies. The group commissioned will work with the department's Advisory Committee on Resource Allocation (ACRA).

Professor Brian Jarman, emeritus professor of medicine at Imperial College London and a member of ACRA, said the idea was that practice resource levels would be calculated by taking into account factors like unemployment levels, number of lone parent families, patients' ages and mortality rates.

He said current techniques based on census data disadvantaged areas where the practice list size was much higher than the registered population, such as inner cities.

'The indication from the data I have is that inner city areas like London are under-enumerated by something up to 20 per cent,' he said.

Dr Gillian Braunold, a GP in Kilburn, London, who has worked with ACRA, said: 'Resource allocation, not only in health but in every part of government is done on census data, which is renowned to be inaccurate.'

Allocating resources according to registered lists offered 'a lot of potential in terms of ensuring resources get to where they are actually needed', she said.

Dr Richard Vautrey, GPC negotiator, said: 'To actually get something that is fair is extremely difficult – there are a variety of factors that interplay.'

Dr James Kingsland, National Association of Primary Care chair and a GP in Wallasey, Merseyside, said a fair shares approach was 'eminently doable' based on current population statistics.

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