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Spending on enhanced services slumps, official figures show

Spending on GP enhanced services in England has slumped to its lowest level for four years, new Government figures reveal.

Funding for extended hours access has also halved since last year, according to latest statistics from the NHS Information Centre.

The figures - published this week in the report Investment in General Practice 2007/08 to 2011/12 - show that overall, annual investment in general practice was up 0.6% - from £9,789 million in 2010/11 to £9,848 million last year. The rise was slightly greater in Scotland - up 0.9% from £741.6 million to £747.9 million.

But while spending on enhanced services increased in Northern Ireland, Wales and Scotland, in England it fell from a high of £835.3m in 2009/10 to £764.4m in 2011/12 - just £7,000 above 2007/8 levels of £756.7m

Local enhanced services in England were hardest hit, with funding for these falling from a peak of £336m in 2009/10 to £269.6m in 2001/12.

The figures confirm findings from a Pulse investigation earlier this month which showed cuts in LES funding of nearly 50% in some areas as managers continue to tighten the screws on GP funding.

On extended hours, the report showed funding had crashed from £75.6m last year to £37.5m this year. DES payments for extended hours were cut from £3.01 to £1.90 per patient in 2011 and as Pulse reported in May this year, PCTs have been inserting clauses in LESs to allow them to reclaim funding for unfilled appointments.

The report also shows PCTMS/APMS funding continues to rise, reaching £362.5m – its highest level for five years.

Premises funding also continues to rise and reached a five-year peak of £661.7m last year, according to the report.

GPC negotiator Dr Chaand Nagpaul said the situation was ‘very regrettable'.

He said:  ‘PCTs winding down, the QIPP agenda and the financial challenges the NHS faces are all having an impact. This matches feedback we're getting from GPs on the ground.

‘It's also likely to be counterproductive. We know that investment via enhanced services is key to delivering the cost efficiencies the government wants to see. If anything, we need to be seeing far greater investment in these.

'It illustrates the short-termism that´s plagued PCT thinking recently. I just hope that post-CCGs there will a more mature approach to investment in GP enhanced services.'

Dr Thomas Reichelm a GP in West Malling, Kent said: ‘In my area, we have next to no enhanced services now. It really gets my goat. We're an easy touch to coerce and threaten.

'It´s all to make up for the constant failure to claw money back from secondary care.'

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