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A faulty production line

GPs to be offered £5 per patient to support rollout of 'named clinicians'

GP practices will be offered additional funding of £5 per patient from the hospitals budget to improve the care of older people and reduce avoidable admissions, NHS England has revealed.

NHS bosses revealed today that CCGs will be told to reallocate the additional funding per head of population from their secondary care budgets in order to support the Government’s plans for a ‘named GP’ for all elderly patients.

A NHS England planning guidance paper reveals that CCGs will be instructed to support practices in implementing the changes to care for patients over 75, and avoidable admissions that were central to the 2014/15 GMS contract.

It states: ‘[CCGs] will be expected to provide additional funding to commission additional services which practices, individually or collectively, have identified will further support the accountable GP in improving quality of care for older people. ‘

The paper also states practices are to be given ‘as much influence as they need’ over associated community services –  nursing and end of life care - so accountable GPs can discharge responsibilities and provide integrated patient care.

The new GP contract for 2014/15 will require practices to give each patient aged 75 years or older a named GP with round-the-clock responsibility for their care. It also introduces a new unplanned admissions DES that requires practices to better plan the care of patients at risk of hospital admission.

Deputy chief of NHS England, Dame Barbara Hakin, said at an NHS England board meeting today that the £5 allocation would help to reverse the flow of funding from primary to secondary care.

She told the NHS England board: ‘[In the] planning guidance we have specifically said that, in addition in [20]14/15 CCGs must identify – somewhere in the order of £5 per head of population – which will come out of their hospital based budget.’

Dame Hakin added: ‘So there are a couple of really concrete things in here that, for the first time, actually start to push that inexorable change that we’ve seen, where the money goes up in secondary care – hospital care- and doesn’t go up in primary care.’

The additional funding for GPs comes as a surprise, as the Government had appeared to rule out any additional funding for primary care in order to carry out the ‘named clinicians’ scheme.

Dr Mike Dixon, president of NHS Clinical Commissioners, said the plans were an ‘excellent idea’.

He said: ‘If we’re going to invest properly in primary care - and we’ve been disinvesting for the last ten years, comparatively to secondary care - we’ve got to do something like that. So I’d say that’s definitely a step in the right direction.

‘But we need to go a bit further, we need to have joint commissioning of primary care and CCG community and hospital services at a local office  level, so we can do more of that. We shouldn’t be waiting for NHS England to say “oh, pop a fiver in” we want to be joined up, so at local level we can make those decisions more thoroughly and perhaps to greater extent.’

The move comes as NHS England announced a major move to provide more funding to CCGs in more deprived areas. The funding revamp will involve 10% of the total budget.

NHS England also revealed at the meeting that that planned reforms to weight the Carr-Hill formula for practices more towards deprived areas will result in swings in funding of a ‘quantum’ of 15% the primary care budget. The changes will take into account population size, age and deprivation - defined by a Standard Mortality Ratio of less than 75.

The document says: ‘At 15% this introduces an increase at one end of the range of £5.65 per head (Greater Manchester) with a reduction of £3.99 per head at the other end of the range (East Anglia and Devon, Cornwall & the Isles of Scilly).’

Readers' comments (18)

  • Seriously? We need to await the detail but £5 per patient for what they appear to be asking us to do seems ludicrously small to me. Moreover, any additional payment for a scheme that involves selected patients, in this case those over 75, should surely be calculated according to the number of patients in that group, not the total number of registered patients.

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  • £5 per patient......**** *** Mr Hunt. What can we possibly achieve with that? This cheeky joker needs to retire and focus on his greedy, MULTIMILLIONAIRE lifestyle.

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  • Is this £5 per patient for all of list size or £5/patient for target group only?
    If former my surgery will receive 5x8400 = £42000/year (enouh to recruite a new part time partner)
    If latter my surgery will receive 5x800 = £4000/year (not even enough to cover 7 days of work by locum)

    If latter, I suspect the extra work involved and the responsibility forced upon us is out of proportion to the funding. But why do I wonder it is going to be the latter......

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  • They could just pay us in bags of potatoes instead

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  • I think it is highly unlikely this money will be paid directly to us as practices. Come on guys and gals - the government have had their fingers burnt before with some of our colleagues pocketing this money. Much more likely groups of practices will be expected to identify what new community based services are needed and either this group will commission directly with local Community Provider or the CCG will do it on their behalf. Only way can get value for money. A practice of 5,000 pts would have £25k to spend, a group of practices covering say 40,000 would have £200k - far more likely to be able to something significant with the latter pot of money. Bottom line is that there is no new money, so along with everything else it's got to be found from somewhere.

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  • Vinci Ho

    Name clinicians ended up as a political jargon or rhetoric . Practically, GPs are to delegate in out of hour as what is happening now.My gut feeling is this money easily going into existing out of hour services but is that enough to make things better for the providers?

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  • Named clinician is a responsibility, With responsibility comes rights -If I am a named clinician for an elderly person will I have legal rights to sue on their behalf? E.g if social services, Out of hour care, Community Physio, dietitics etc fall below standard -Can I sue them on patients behalf.
    After all if other services fail someone why should the named clinician be responsible?

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  • £5 per patinet - to community services? Nothing for the GP who has to set it all up? It will be swallowed up by district nurses, night sitters & social services care agencies putting up their prices.

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  • Vinci Ho

    When we gave up out of hour duty in 2004 , nine years ago , we gave £6000 per GP back to government :
    Take an average of 2000 patients per GP( you can criticise the accuracy of this ):
    A population of 200,000 is served by 100 GPs-
    £5.00 a patient - hence one million pound for this population .
    But £6000x100=£600,000 in 2008 was for out of hour.
    That leaves us only £400,000 to play with BUT hello ! there is something called inflation and depreciation of currency especially with the government printing more money (quantitative easing) and uncontrolled rise in cost of essential commodities like power , electric etc.

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  • This isn't new money. I shall be seeing the CFO of our CCG later. I'm not sure what sort of a mood she will be in, having been told she will need to find £1.25m out of a budget that is already as overstretched as Peter Crouch's socks.

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