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GPs left facing funding shortfall as extra investment in enhanced services fails to materialise

By Gareth Iacobucci

Exclusive: Fewer than half of PCTs have increased their investment in enhanced services this year, despite repeated Government assurances that GPs would be able to offset successive pay freezes with extra investment.

A Pulse survey of every PCT in England, carried out under the Freedom of Information Act, shows that just 60 increased their spending on enhanced services this year, with 54 actually reducing their investment. In seven PCTs spending remained the same, while the remainder were unable to provide the figures requested.

The investigation shatters claims made by the previous Government that GPs would be able to earn more from enhanced services to compensate for pay freezes, with the overall investment only half that projected by NHS bosses.

If extrapolated to all 151 PCTs, the figures show trusts' overall spend on enhanced services rose by almost 5% in 2010/11, from £373m to £391m. But this increase of around £17.7m falls some way short of NHS Employers' projection that GPs would receive an additional £30m - £50m increase through local enhanced services.

Among the trusts making big cuts to their investment were NHS North Yorkshire and York, which reduced enhanced services spending by £1.5m, NHS Derbyshire, with a £1.4m reduction, and NHS Portsmouth and NHS Liverpool, which both cut spending by £1.3m.

The biggest increases in investment were made by NHS Heart of Birmingham, which pumped an additional £2m into enhanced services this year, and NHS Herefordshire, which upped its spending by £900,000.

Dr Chaand Nagpaul, GPC negotiator with responsibility for enhanced services, said the investigation laid bare the ‘postcode variation' that had seen investment cut in many areas.

He said: ‘In general, we feel investment in enhanced services has been woefully under-utilised by PCTs. All too often, it is seen as a drain on expenses rather than a solution to reducing the strain on secondary care.'

‘Investment in enhanced services should be seen as a solution to reducing PCT expenditure. The fact that in nearly half of PCTs investment has reduced is lamentable.'

He added: ‘We would want to ensure that the new white paper commissioning arrangements enable GPs to provide a greater range of enhanced services, to make proper use of the potential.'

Fewer than half of PCTs have increased investment in enhanced services View the full results

To download the full results of Pulse's investigation and see how your PCT compared, please click here.

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