Weekly round-up: GP hard times blues

GP hard times blues

It may have passed you by, overtaken perhaps by the continuing fall-out over the Bawa-Garba case, but the deteriorating state of the NHS finances is not looking good.

Half of CCGs are staring at financial deficits this year, totalling over £700m. This is despite over £500m worth of budget cuts made during this financial year. Their allocations will increase from April and there has been a million-pound ‘sustainability fund’ put aside to help dig them out of this hole, but NHS funding per head is falling.

What does this mean for GPs? Well, for a start, many will struggle to invest the £3 per patient promised for practices – many were waiting until this year to allocate the full amount. CCGs have also been instructed to invest more into mental health and the continued ‘winter’ crisis in urgent care is expected to suck up any additional resources

It looks a long way to go before GP funding rises to the promised 10%+ of the NHS budget (it is currently 7.1%) and public health won’t be coming to the rescue – they have cuts of their own to implement.

The truth is that NHS managers are being given an ever-lengthening list of demands, without adequate resources to deliver on them. Something has to give at some point – and usually the first area to get snipped is primary care.

As a modern Ray Charles may have sung: ‘Lord those hard times. Who knows better than general practice?’

It is going to be a tough year.

The hardest word?

The GMC is clearly worried. BBC Five Live had a long special this week on the Bawa-Garba case and Pulse editor Nigel Praities was invited to speak about the cover of this month’s Pulse magazine and the strength of feeling among doctors about the case.

Following that interview, the chair of the GMC said he was ‘extremely sorry’ for the effects the case has had on the medical profession. He said: ‘I’m a practising doctor on the front line and I completely acknowledge the pressure they are under and the sense of distress in the profession that this case has caused,’ he added.

The LMCs Conference vote of ‘no confidence’ in the regulator last Friday has also reverberated around the medical profession, although its recommendation that GPs should be told not to prepare written reflections may have a longer lasting effect on how mistakes are dealt with in the NHS.

The fallout from the Bawa-Garba case looks like being negative and long-lasting.

Is longer, better?

Not always, it may be when it comes to prescription intervals. A study looking into the arbitrary 28-day restrictions some areas put on prescriptions from GPs has found little evidence to support them.

The study found that although longer prescribing intervals do produce more waste, they cost less overall when GP time and dispensing fees are taken into account. Something to take into your next meeting with the health board/CCG.