This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

This bitty approach to funding fails GPs and patients

Editor’s blog

jaimie kaffash 2 duo 3x2

Rejoice! NHS England is ahead of its target in ploughing money into general practice, it claims. It says it has increased investment by £580m – representing a 3.9% boost above inflation.

The BMA challenges the figures, saying that this includes elements such as drug reimbursements and GPs in A&E. But, despite this, it does acknowledge that there has been a funding boost.

Which is great. But there are obvious caveats. First, and obviously, it is not enough. There are fewer GPs in the system, workload isn’t decreasing, waiting times are increasing. Until these are reversed, then the NHS and the Government cannot say their funding boosts are adequate.

But, in fairness to NHS England, they are constrained by what they are given by the Department of Health and Social Care and the Treasury.

The NHS should bite the bullet and significantly increase core funding

However, there is another problem with the funding – how it is given to practices. The funding listed by NHS England includes GP Forward View programmes, the Estates and Technology Fund, seven-day access schemes, transformation funds, schemes to expand the GP workforce, etc.

This bitty approach to funding is unhelpful. First, it prioritises those practices that are in a position to deliver on these schemes – typically, the larger practices beloved by NHS England, who generally are in a better financial position than smaller ones.

Secondly, and more importantly, it doesn’t get to the root cause of the problems in general practice. As one GP put it, the current funding system is like ‘trying to paint a house armed only with multiple tiny pots of paint’. At the same time, this leads to only short-term planning, with practices unsure over whether these various funding pots will be withdrawn the following year.

Instead of funding these bitty schemes, the NHS should bite the bullet and significantly increase core funding. It is the only way to get us out of this crisis. I understand it is politically tough, and that the Government would be terrified of headlines about lining GPs’ pockets, but they must know this is the only way to improve services for patients. Interestingly, NHS England’s new director of primary care seems to understand this. Let’s hope she can make the case to the holders of the purse strings.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at


Rate this article  (4.67 average user rating)

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Readers' comments (7)

  • End of the line?

    Adequately feed the dog or let if off the leash so it can fend for itself.

    General practices needs to set up like dentists
    able to do private AND nhs funded work..

    Unsuitable or offensive? Report this comment

  • The private members bill getting its second reading next month, under the radar of Brexit, may release the shackles and allow practices to charge patients.
    The government aren't worried about headlines about bankers lining their pockets nor any business except health.

    Unsuitable or offensive? Report this comment

  • ‘But, in fairness to’ ...blah, blah, blah
    - just ‘mount up and ride for the guns’

    Unsuitable or offensive? Report this comment

  • I think there needs to be some caparison to how much better (or worse) the entire system would be if the different pots of money were just all mashed in to the global sum for GMS and PMS practices (NOT APMS - as that often includes politically driven KPIs).

    A local weekend access provider pays nurses (not nurse practitioners) just under £50 an hour to sit in clinics that are half empty on a Saturday. That is not a good use of resources.

    The same money pumped in to primary care, might have delivered inflation matching pay changes over the last 10 years, which in turn would lead to more GPs, fewer retirements and fewer people moving abroad. That might have had a much bigger impact on the service than changing Mrs Blogg's dressing on a Sunday rather than a Monday.

    Unsuitable or offensive? Report this comment

  • Jaimie, your heart is in the right place, as always. The problem is that "general practice' is a broad church and includes not just GPs but also the MANAGERS, who ensure that they and their favourite GPs get the lion's share.

    Unsuitable or offensive? Report this comment

  • "General practices needs to set up like dentists"

    My sister is earning £50K only 2 years after graduating from dental school. Yet her conscious is still clear as the majority of her work is NHS.

    Try telling that to an F2 slaving away on a night shift.

    Unsuitable or offensive? Report this comment

  • Let common sense prevail

    NHSE have a mantra that every new tranche of money, however small, has to be justified by a business case showing what it will get in return. In other words "new money = new work". Since the accepted problem is too much work already, is this going to lead to a solution?

    Murphy tells his boss that his barrow isn't big enough to carry all his bricks. 'No problem' says the boss, 'I'll get you a bigger barrow, but in return you'll have to carry more bricks'

    Unsuitable or offensive? Report this comment

Have your say