The GPC has passed a motion instructing negotiators to work with the Department of Health on plans to change GP practice funding allocations to take account of deprivation factors.
The move marks a shift in the GPC’s negotiating position on the controversial topic, after it decided last year that changing the Carr-Hill allocation formula at all, at this moment, would be too disruptive to practices.
The Government is currently consulting on a wide-ranging revamp of the GP contract which includes a review of the Carr-Hill weighting tool to take into account deprivation and the removal of the minimum practice income guarantee (MPIG) over a seven-year period.
In its latest newsletter, the GPC said: ‘There is evidence to suggest a link between deprivation and ill health, particularly the instance of multiple co-morbidities. GPC members agreed that deprivation can increase practice workload and a motion was passed to the effect that GPC will work with the Department of Health to introduce either a deprivation allowance or other recognition of increased workload in deprived areas.’
However, it added a caveat that to tackle the health problems associated with deprivation, improved resources would be needed in other areas, such as social services.
The motion was put forward by two members of the GPC who are not part of the negotiating team and was passed in voting at the most recent GPC meeting on 20 December.
It marks a new twist in the long-running debate which last saw the profession consulted in 2007, after the Formula Review Group made a number of far-reaching suggestions on how to make the Carr-Hill formula fairer. The group, which included representatives from the GPC, NHS Employers and the DH, concluded that including a measure of deprivation in the workload adjustment element of the formula was likely to result in a ‘small benefit’ but it was unclear how it would be effectively implemented.
The Formula Review Group’s report is now due to be updated by the NHS Commissioning Board and negotiated on next year – although the DH has warned that if no negotiated solution can be reached it will ‘consider whether to pursue the improvements’.
Commenting on the GPC motion, negotiator Dr Chaand Nagpaul said: ‘We don’t know what will happen because last time we looked at this, we found that it led to a whole new set of questions. How much weighting? What element of deprivation? It is quite a broad task, so we don’t know at this stage how this will work in practice.
‘Even the Government has not specified how, and the motion does not specify how. It has simply said “look, practices working with deprived populations don’t have recognition for the added workload”. The motion did not say this had to be via the Carr-Hill formula being changed. It should be recognised via the formula or some other means. This decision will inform our negotiations going forward.’
He added: ‘This will not affect the process of how MPIG is redistributed, but it will affect some individual practices’ global sum and therefore it will affect how soon they come off MPIG. This does not affect the mechanics of how we will agree the removal of MPIG.’