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Gold, incentives and meh

Practices 'could miss out on £760m' as NHS focuses on hospitals, claims RCGP

Practices could be missing out on hundreds of millions of pounds by 2020 because plans being devised across England by NHS managers are ploughing money into trusts’ deficits, RCGP chair Dr Maureen Baker will warn today.

In her final speech as chair at the RCGP conference in Harrogate, Dr Baker will cite the analysis by the college that also reveals that CCGs who have taken on responsibility for commissioning GP services have underspent by £33 million on primary care this year.  

Dr Baker will say that the failure to spend on primary care, and vulnerable practices in particular, is a ‘national disgrace’, and that RCGP representatives are ‘struggling against an agenda that is focused on plugging ever increasing hospital deficits’.

The RCGP’s analysis of the secretive ‘Sustainability and Transformation Plans’ (STPs) - the blueprints for the future of the NHS being worked up in every region in England - found no evidence that funding was being committed to general practice.

Pulse has already revealed local GP leaders’ concerns about the lack of GP input into local STPs, which are being drawn up between CCGs, NHS England regional offices and local authorities.

NHS England has said that it ‘will not sign off plans unless they support GPs’, and advised STPs that 15-20% of their budget should be allocated to support primary care and general practice by 2020/21.

But the college’s analysis suggested that this potential 20% of funding is not making its way to general practice - amounting to approximately £760m.

Dr Baker will use her speech to call on NHS chief executive Simon Stevens to ensure STP regions start publishing their financial plans, including committing funding to general practice.

She will say: ’The STPs will play a crucial role in shaping the future development of the NHS over the next five years. However, strengthening general practice should be at the heart of what they are about.

’But in many areas RCGP local representatives are struggling against an agenda that is focused on plugging ever increasing hospital deficits.’

She will add: “Based on the limited information about STPs that has been published, very few contain specific pledges to earmark extra funding for general practice. Some barely acknowledge general practice at all.

“If STP plans fail to deliver the funding for general practice – from the Sustainability and Transformation Fund – then the family doctor service stands to lose up to £760m in 2020/21.’

The college has also analysed CCG budgets, published last month, which reveals that they are on track to underspend their funding allocation on general practice by £33m in the current financial year. The RCGP said this represents a ‘double whammy’ for practices. 

The Labour Party has committed to fight STPs which have come to be known as ‘secret plans’, and which Pulse has revealed will see significant cuts in GP surgery numbers as part of moves toward sustainability.

An NHS England spokesperson said: ’We are working hard to relieve pressures on GPs and this includes increasing funding for general practice by £2.4bn a year by 2021 - a 14 percent real-terms increase.

‘This demonstrates our commitment to strengthening GP services and as part of these efforts we have highlighted that local areas, through their Sustainability and Transformation Plans, need to set out how they will further support general practice, both now and in the future.’


Readers' comments (10)

  • Hospitals have to pay their employees a guaranteed sum (or more if locums).
    Costs are escalating
    Nobody at the top to take a reduction in income to make up for the shortfall.
    The result is annual deficits.
    Hospitals are large, politically important and can not fail
    CCG bail out

    GP Partners have to pay their employees a guaranteed sum (or more if locum).
    Costs are escalating
    GP Partners take a reduction in income and/or become more productive
    The result is no annual deficits
    Even if profits go down and GP Practises close there are always other practises nearby to pick up the work
    GP Practises are small and 'individually' not politically important
    No CCG bail out

    That is why CCGs will always put hospitals first

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  • But GPs are supposed to be in charge of CCGs

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  • Mr Mephisto

    Last year The Northern Ireland Assembly found £40 million "down the back of the sofa" to invest in health care. They gave £39.1 million to secondary care and £0.9 million to Primary Care - it shows how much they value Primary Care. We will see how well A&E copes when the GP system implodes. All that cash that they invested in A&E would have gone a long way to stopping the rot in GP land. The rural areas are starting to implode already with practice closures. Within the next five years rural border areas in South Armagh, Fermanagh, and West Tyrone will be un-doctored. Let the politicians try an explain that to their electorate. "Transferring Your Care" is a great political whizz -they give all of the money to Secondary Care and all of the work to Primary Care

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  • She is of course correct - STP is about hospitals - and as asiad above politically cant fail (even if some need making smaller or closing altogether).
    But yes to reduce hospital costs requires GPs to take on work - which we wont do here at least without resources (money AND staff)

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  • Not all CCG get it wrong.
    Ours have big practice leads. They get extra funds regularly.
    Going back to 70s where large units just failed to deliver good care

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  • Dr Meph It was 62 million. Our % has fallen from 11 to 5.5% in 11 years, yet we see 90% of all face to face consults in the NHS and this has increased by 50% from 4 to 6/ per pt year.
    It is quite simple actually, if we and our leaders are happy to see patients at 50% of what we got in 2005 per consult, the DOH are happy, happier still if we see more and more for less.
    No wonder, they think GPs are stupid.
    They have a point.

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  • I suspect that neither primary nor secondary care will ever get this money
    Smoke, mirrors and politicians "exaggerations"

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  • 6:26 so all get your heads out of the sand and work together at scale! The longer you spend dithering about working at scale, the more vulnerable you are to external corporates.

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  • 7:43: Health professional- who do you represent - working at scale is not a solution for underfunding. No wonder you are already 'other healthcare professional' if at all you were a gp.

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  • Why the hospitals always win?
    * a staggering 93% of the top NHSE managers are of hospital background
    * The BMA has been and always will be consultant-led
    * Most people working in hospitals belong to powerful trade unions - Unison, Unite, Alliance...
    * REAL Royal Colleges of hospital specialities are treated with respect by the Government, unlike the General Practice's hilarious counterpart.
    * Consultants have a respectable HSCA to represent them, unlike toothless LMCs who run with the hare and hunt with the hounds
    * Closing down a surgery is nothing to local MPs, but closing down a hospital spells their political death.
    (there is more, but time to update QOF)

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