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At the heart of general practice since 1960

Managers in 13 areas fail to pass on funding to help reduce GP waiting times

Exclusive Most CCGs have invested a proportion of the funding mandated by managers to ensure in-hours GP access is improved, but 13 have yet to invest a single penny.

The £3 per patient 'transformation' funding was promised nearly two years ago in the GP Forward View, but Pulse has learnt that in a number of areas no funding has been released this year to ensure improved opening times.

This is despite long waiting times for GP appointments, which the RCGP said this was a 'risk to safety'.

CCG allocations were increased this year with the expectation that they would release this funding over two years from 2017/18, to support practices to work ‘at scale', implement ‘ten high impact actions’ to free up clinical time and 'secure sustainability of general practice to improve in-hours access'.

An FOI request by the BMA to CCGs has found that nearly two-thirds of CCGs had given £1.50 or more per patient funding in 2017/18.

But a fifth have given less than half the required funding this year, with less than £1.50 going to practices, and some 6% of CCGs have allocated nothing at all this year, although all have promised to allocate the full £3 per head next year.

The £171m funding was outlined in the GP Forward View in April 2016, and was part of NHS England's 'turnaround' package for the profession.

CCGs' budgets were increased to reflect this funding, and they have been told by NHS England to pass it on to GP practices over 2017/18 and 2018/19.

The BMA sent freedom of information requests to all 208 CCGs in England asking how much they have committed to general practice transformation, which was answered by 203 CCGs. It said it was pleased that most CCGs seemed to be passing on this money, but warned some commissioners were failing to do so.

Dr Chandra Kanneganti, the GPC’s GP Forward View lead who co-ordinated the survey, told Pulse that the BMA GPC ‘want to make sure every penny promised in the GP Forward View is delivered’. He said: 'It's reassuring to note that number of CCGs are spending this money on practices to work at scale, on GP federations and networks. But we are also disappointed with the few CCGs who still have not identified proper action plans to spend this money.'

Dr Kanneganti said: ‘It may be a lack of motivation or a lack of understanding that it is a “must do”, or a signal that it is not a priority.

‘We want to make CCGs understand that it is a high priority and it will benefit the CCGs themselves by investing in primary care.The reason number of CCGs are in deficit currently is that they were spending money at the wrong places and any investment in primary care will give better returns and help in the long run to reduce their deficits.’

In a letter to LMCs, Dr Kanneganti wrote: ‘Please do contact me if your area is facing any challenges accessing this funding. We will also be monitoring if this funding has been provided in the survey that we will issue to LMCs at the end of the financial year.’

Pulse reported last year that NHS England is undertaking a review of CCG spending to ensure that the £171m is being spent.

The RCGP’s July 2017 report on the progress of the GP Forward View’s pledges highlighted that many CCGs had blocked out the money for practices in 2017/18 and 2018/19, but other areas had yet to do so.

NHS England declined to respond to the findings. Click here for individual CCG responses.

The unlucky 13

  • NHS Harrogate and Rural District CCG 
  • NHS Herefordshire CCG 
  • NHS Mansfield & Ashfield CCG/NHS Newark & Sherwood CCG
  • NHS North Kirklees CCG
  • NHS North Lincolnshire CCG
  • NHS North, East and West Devon CCH
  • NHS Nottingham North and East CCG/NHS Nottingham West CCG/NHS Rushcliffe CCG 
  • NHS South Devon and Torbay CCG
  • NHS Thurrock CCG 
  • NHS Vale of York CCG 

And those who failed to respond:

  • NHS Heywood Middleton & Rochdale CCG
  • NHS Milton Keynes CCG
  • NHS Newham CCG
  • NHS South Tees CCG
  • NHS Trafford CCG

For the full results, see our map

Readers' comments (12)

  • Extremely interesting that Sunderland is the only CCG in the NorthEast to have spent the full £3.00 on supporting General Practice and improving patient access.

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  • NHSE in Kent gave 106 monies around 1 mln to Medway CCG about 5 months ago. This was money that was withheld from developments since 2010.
    The CCG has not allocated this money to anybody for 4 months.
    Medway does not figure on the list.
    A total of 3 million of withheld 106 money was identified for Kent by the MP Kelly Tolhurst and GPs in her Locality were informed about it. But why are the CCGs holding it back?
    Allocations should be transparent and information about who is being funded and for for what. This information should be shared with all GPs in the County.
    Lack of this transparency leads to gross corruption and apartheid with some being favoured while others are put down.

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  • You can add Somerset to the list

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  • Can add Lincolnshire to the list.

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  • But in many places the money is not getting brought tingeberal practice at all. Many places are re-badging other projects that were in place before the allocation as part of the spend; others are spending it on barely-relevant pet projects without discussing it with practices or the local LMCs. The problem with he GPFV is how little if the money actually ends up either in or directly supporting practices. The only realistic solution is an uplift in core funding for all practices. Perhaps in the aftermath of the current crisis our leaders might consider playing a little hardball, and threaten to do what the dentists did?

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  • Lincolnshire CCG, the hot spot for non recruitment does not appear to be supportive.

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  • The ring of transformation funding is as translucent as every other funding in NHS. It would be great if a list of total funding disbursed by CCGs and publishing of a list of beneficiaries was made mandatory. Some Practices seem to have a monopoly while others can't get a penny in 7 years (because of racial distinction?)
    You can't even get a stair lift if you are blacklisted - so much for improving patient access!!

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  • Doctor McDoctor Face

    Bedfordshire has been pondering a home visiting service but nothing yet has happened.

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  • postcode lottery, not only for patients but primary care too

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  • Vinci Ho

    Incidentally , have you guys read this latest editorial in BMJ?

    http://www.bmj.com/content/bmj/360/bmj.j5911.full.pdf
    CCGs fail to declare pharma funding
    Tom Moberly

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