A slightly larger proportion of London practices have signed up to do the DES for avoiding unplanned admissions than colleagues in the north, Midlands and East.
In total, 93% of London practices have taken on the enhanced service that is worth £20,400 to the average practice, compared with 89% in other areas previously reporting take up figures.
The average take-up across England now stands at 90%, with the south of England area team yet to report, leaving one-in-10 practices still turning their back to the associated workload of the DES but paying the price by taking a huge cut to their income.
GPC deputy chair Dr Richard Vautrey said the take-up figures were in line with expectations but a bit higher than what is common for other enhanced services, likely because of the substantial financial value to practices.
He said: ‘I think that is in line with what we would anticipate. I think if you look at the take up of previous enhanced services it is often much lower than that but this is a significant resource that practices can ill afford to lose. Even with the additional workload that it will bring, they need every penny to actually ensure that the practice remains stable and can provide services on an ongoing basis.’
Although it would depend on the size of the practices that have scorned the DES, this could mean that some 10% of the GP funding which was released by shrinking QOF by 40% for this year’s contract – possibly equating to some £20m – could potentially be lost to general practice.
Asked what would happen to the money, NHS England said area teams could use it to fund primary care services in general. A spokesperson said: ‘Any money not spent on the unplanned admissions DES will remain available for area teams to use to commission primary care.’
Dr Vautrey said that money not being spent is ‘always a risk’ with enhanced services but that the important thing is for NHS England to ensure that ‘every single pound’ of the savings made is spent on general practice and ‘not just handed back to the Treasury’.
He added: ‘It is a concern. When we have got so little funding for general practice a loss of anything is unacceptable and we need to ensure that the monies that have been identified for general practice is used for general practice. What we need is additional money. What we can’t afford is to lose the limited resource that we have got.’