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GPs’ enhanced service funding boosted by 75%

Exclusive CCGs are ploughing more money into general practice, with practices receiving almost £200m extra from commissioners since 2013/14, a Pulse investigation reveals.

A freedom of information request answered in full by 48 CCGs revealed that spending on enhanced services has increased from £59m in 2013/14 to £103.5m this year.

Extrapolated across the country that equates to £195m of new local contracts for practices.

GP leaders welcomed the shift, and said it is proof that CCGs are beginning to understand that resources are best off moved towards primary care.

CCGs had been told to reinvest the £260 million saved from the PMS reviews and any money saved from MPIG back into primary care.

But Pulse’s investigation reveals that CCGs are ploughing more of their own money in to enhanced services, with the majority of the PMS and MPIG money not yet clawed back from practices.

Many CCGs are offering packages to practices – single pots of money, bringing all enhanced services together to reduce bureaucracy for practices. These include:

  • NHS Bristol CCG’s £1.8 million ‘Bristol Primary Care Agreement’, which tasks practice clusters with initiating and following up dementia medication and diagnosing deep vein thrombosis in primary care among other things.
  • NHS Salford CCG’s ‘Salford Standard’, a list of 32 standards that includes ensuring patients with severe mental illness are given annual physical health checks and offering longer appointments to asylum seekers.

Elsewhere, other examples of CCGs ploughing in money to primary care include:

  • NHS East and North East Hertfordshire CCG, which has more than trebled for its care home enhanced service since 2013/14, from £220,000 to £774,000, with GPs expected to offer the ‘equivalent of ward rounds’ in care homes;
  • NHS Rotherham CCG, which has been able to shut three wards in its local hospital because of additional services provided in general practice, including practices setting up multidisciplinary teams, putting admission-prevention plans in place and discussing all care home admissions;
  • NHS Blackburn and Darwen CCG, which has asked its GPs to work together to devise a plan for a proposed £6m investment in primary care services, pooling all the money spent on current enhanced services, such as those for prescribing in the elderly and boosting uptake of bowel cancer testing.

Dr Brian Balmer, a GPC negotiator, said: ‘It’s great to hear some good news for once. My experience is that most CCGs want to develop community services and GP practices – they have a real desire to develop primary care.

‘CCGs are getting better organised, particularly when it comes to care of elderly or frail patients.’

Dr Graham Jackson, co-chair of NHS Clinical Commissioners and chair of NHS Aylesbury Vale CCG, said: ‘We are seeing a shift and there is a desire for primary care investment. We know we need to invest in community care. Shifting resource from secondary care to community care is the way forward and is the best way of using that resource.’

Pulse reported this week that, separately from the enhanced service funding, CCGs have spent tens of millions of pounds to support practices set up federations.