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 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).’