GPC calls for 'clear financial arrangements' amid neighbourhood funding uncertainty

The BMA has called for ‘clear financial arrangements’ to underpin the new neighbourhood care models proposed by the Government, following the 10-year plan’s lack of detail around funding.

In new guidance to practices and GP federations, the union’s GP committee warned that without safeguards, the plan risks funding ‘flowing to higher tiers of the system’ or corporate entities ‘with minimal transparency’.

The 10-year plan did not announce any new funding for general practice but pledged several changes to funding flows, including two new contracts for neighbourhood services, which ICB can award to other providers, and ‘year of care payments’ which could see other NHS organisations take on budgets for general practice services.

It comes after one large ICB has already chosen a number of hospital trusts to oversee the new ‘neighbourhood health service’ across its footprint, announcing that the trusts will also hold the funding.

GPs and experts told Pulse that the proposals could mean that funding will mostly be channelled into larg-scale providers and that traditional practices will be left with fewer resources.

Now the GPC said that to safeguard practices and GPs working within them, neighbourhood care models should be ‘underpinned by clear financial arrangements, workforce planning, and infrastructure support’.

It warned that the current system offers ‘no guarantee’ that financial surpluses which the neighbourhood model is supposed to generate would be given to practices.

It said: ‘GP-led providers working at scale often deliver efficiency gains by reducing duplication and coordinating care across settings.

‘But when these efficiencies generate financial surpluses – whether from reduced hospital activity, innovation funding, contractual delivery or delegated commissioning – the current system offers no guarantee that this value is returned to the practices or teams responsible for it.

‘Re-investment of such surplus back into member practices’ services and staff will help generate even more gains by improving preventative and continuity of care.’

The guidance added that practices should demand a ‘published annual surplus reinvestment statement’ as part of the plans, which should set out how any surplus was generated and detail how it was allocated ‘across member practices, workforce initiatives, or service development’.

It also suggested that practices should ‘map opportunities and risks’ related to the plans.

It comes after GP leaders in one area advised practices to hold off from taking part in new ‘neighbourhood health programmes’ announced as part of the 10-year plan, amid a lack of clarity around funding.

The GPC added: ‘While there is momentum for change and pressure from NHSE and ICBs to push ahead at speed, it is important for GP practices and federations to try and manage the pace of development thoughtfully.

‘Rapid, top-down implementations risk disengagement and burnout, whereas a measured, stepwise approach allows for iterative learning, adaptation, and consolidation.’

Pulse has contacted the Department of Health and Social Care for comment.

Earlier this month, the Government announced the first phase of the rollout of neighbourhood health programmes following the 10-year plan, with 42 areas to be chosen to pioneer the new model from September.

NHS England asked ICBs to submit applications to take part, by outlining examples of ‘joined-up working and innovation’ in their areas, including working with GPs, other local health and care providers and voluntary groups.