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At the heart of general practice since 1960

The Budget hasn't quite left the NHS alone

Primary care has got off fairly lightly - but there is a sting in the tail for hospital discharge

By Richard Hoey

Primary care has got off fairly lightly - but there is a sting in the tail for hospital discharge



Writing about the budget with the speech still echoing across the Commons, and with a 268-page monster of a supporting document lying skim-read in your in-box, is always a risky business.

There isn't time to decode the spin, let alone to dig behind it at the complex web of numbers that will tell the real story about the financial future of the NHS.

So I'll have to make do with a few first impressions – of the best and worst of the budget for general practice.

The best is straightforward enough, and definitely worth a sigh of relief. Primary care has been spared what may turn out to be savage cuts in public spending elsewhere.

Quite the opposite – as the deliverers of a ‘frontline public service', PCTs will get a moderately healthy 5.5% uplift in each of the next two financial years.

It's far from the fantasy increase trusts got used to receiving in the early Labour years, but there will be many an art gallery or public library that will cast an envious glances in the direction of the local health service.

But while the headline uplift means there should still be some money for enhanced services and PBC schemes, it definitely doesn't mean GPs will escape the consequences of the overall budgetary squeeze.

The Department of Health has been asked to make savings of £2.3 billion in its budget, and it expects to find £500 million of that in getting patients out of hospital more quickly.

Pulse of course has been on top of this growing pressure on hospital discharge for some time now – most recently in reporting that acute beds have been cut by 10% in just the last three years.

And we've reported on the sharp jump in the rate of emergency readmissions that has occurred at the same time – which has included an increase of a third in the rate of readmissions within a day of discharge.

The DH has somehow managed to shrug off those consequences of its clampdown on hospital activity up until now, simply denying any connection between the two trends.

But that's going to be harder to do as the moves to shove patients out of hospital get more desperate – and the consequences more clear-cut.

BMA Wales is already warning that patient safety is being put at risk.

This is one short-term saving the Government may regret.

By Richard Hoey, Pulse deputy editor

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