Government announces six-month review of GP funding formula

The Government has announced a six-month review of the Carr-Hill funding formula starting today.

Citing Pulse’s award-winning investigation into practice closures, the Government said that data shows that on average the GP practices that close for good are in areas with areas of higher deprivation.

First floating the new review earlier this year, health secretary Wes Streeting pledged it would result in ‘working-class areas’ receiving their ‘fair share of resources’.

Also known as the global sum allocation formula, it was introduced with the 2004 GP contract to ensure funding reflects factors influencing patient needs and costs, such as age.

However it has been frequently criticised for not sufficiently taking into account deprivation factors and has been subject to several attempts at review, with the first one taking place in 2007.

Ahead of his attendance at the RCGP conference in Newport today, where the review is expected to be announced, primary care minster Stephen Kinnock said: ‘The way GP funding is allocated is outdated and no longer fit-for-purpose – with more deprived areas and coastal communities across the country experiencing the highest levels of inequality.

‘With GPs at the heart of our 10-Year Health Plan, it is vital that we don’t leave any community behind and that we end the postcode lottery of care.

‘As we invest in primary care – we must prioritise the areas and communities which have the most need to drive health improvements and close the gap on these health disparities.’

Pulse has asked the Department of Health and Social Care to clarify the terms of reference for the review and who will be part of the review group.

It comes as the BMA said it has been told the review may need to be ‘cost neutral’, prompting warnings to avoid destabilising practices from whom funding may be removed.

NHS England national director for primary care Dr Amanda Doyle said: ‘It is essential that GP practices serving our most deprived communities, where health challenges are often greatest, receive a fair share of resources that reflects their need.

‘By overhauling GP funding for the first time in two decades, the NHS can better help people to get the support they need as GPs and their teams deliver record numbers of appointments for their communities.’

RCGP chair Professor Kamila Hawthorne said: ‘A review of the funding formula for general practice is long overdue and something the College has called for, alongside an uplift in funding for general practice overall. 
 
‘A patient’s postcode and where they live should not determine the level of NHS care they receive. It can’t be right that people in deprived communities – who often have more complex health needs and would therefore potentially benefit from health interventions most – are less likely to receive it, because GPs in deprived areas are responsible for hundreds more patients per head on average than those practising in more affluent areas.’

Nuffield trust deputy director of research Sarah Scobie said: ‘The Government deserves real credit for tackling the huge inequity that sits at the heart of how money for general practice is allocated in England – a problem that has persisted for many decades. The current “Carr-Hill” funding formula is outdated and reinforces the unfair reality that people in poorer areas get poorer healthcare. If implemented successfully, this approach could also help with the government’s aim to shift the focus of healthcare from treatment to prevention.

‘But such reform will need to come with additional funding and will require a concerted effort across government and the GP profession to ensure that some areas don’t lose out as cash is redistributed.’

Last month, Mr Streeting told the BMA Special Representative Meeting that he will ‘work with’ GPs to avoid ‘unintended consequences’ of the formula review.

Pulse’s investigation Lost Practices found that on average, practices that close for good are in postcodes that have a ranking of around 3.81 on the Index of Multiple Deprivation, compared with a national average for practices of 4.41 (with 1 being most deprived, 10 being least deprived).