NHS England has said it was ‘forced’ to cut primary care transformation funding last year due to inflation and energy cost pressures.
The national commissioner’s annual report for 2022/23, published yesterday, said it needed to find extra funding to cover higher energy costs and inflationary pressures.
As a result, NHSE had to cut other funding streams, particularly for primary care and digital investment.
The report said it was a ‘very challenging year’ for the NHS due to a ‘real terms cut in core funding’, a high rate of inflation, and operational pressures such as industrial action.
Recent figures showed that general practice funding per patient has seen a real terms cut of 7% since 2019.
The NHSE report said: ‘At the start of the year, we were forced to issue additional inflation funding of £1.5 billion to cover higher energy costs, a direct impact of inflation on index-linked contracts and other inflationary pressures.
‘This required us to reprioritise transformation funding, in particular cutting funding for digital investment and for primary care.’
As well as these inflation pressures, the NHS also saw a real-terms reduction in total funding of 0.6% in 2022/23 compared to the previous year, mainly due to reduced Government funding for Covid-19.
NHSE declared its operating expenses for GP primary care services as £796.5mn in 2022/23, which is a reduction of around 38% from the £1.28bn the year before.
However, the total operating expenses for general practice including CCGs and ICBs increased over the same period, from £11.4bn to £11.5bn.
Former BMA chair and chair of the North West London LMCs network Dr Chaand Nagpaul told Pulse it is ‘inexplicable and counterproductive’ to make cuts to primary care as this ‘inevitably’ results in more pressure on hospitals.
He said: ‘I find it very concerning that NHS England chose to yet again use primary care as a soft target as the source of its cuts. This is also counterproductive at a time when the pressures in the NHS need a stronger primary infrastructure if we are to manage patients in the community to actually reduce hospital pressures.’
‘NHS England chose to single out primary care as the only sector to make cuts from,’ Dr Nagpaul added.
The report pointed to NHS England’s efforts to increase the primary care workforce, stating that by the end of 2022/23 there were more than 29,000 extra direct patient care roles.
But NHS leaders admitted that ‘retention of the qualified GP workforce remains a significant issue’.
They also said a financial priority for this current financial year is to ‘use the specific resources’ they have been given to ‘continue to increase’ investment in primary care services.
GP practices have been locked into a five-year contract since 2019, but this will come to an end in March.
The BMA recently surveyed grassroots GPs on their wishes for the future contract, and the GP Committee (GPC) chair told Pulse that the Government’s offer will be put out to a referendum next month.
In November, GPC chair Dr Katie Bramall-Stainer told LMCs that GPs deliver ‘phenomenal value for money’ despite receiving just 7.2% of the NHS budget.
The committee is also arguing for the inclusion of GPs within the Additional Roles Reimbursement Scheme (ARRS), as a potential solution to financial pressures across general practice.
Great well this year we can see inflation is heading back to normal and will be <2% for april, gas and electricity prices are much improved and the energy price cap for residential deals is on the way down.
So we can expect a full correction on the previous funding to be included this year.
Disappointing lack of credibility. Just look at today’s report of how NHSE/DHSC allowed Acute Trusts to keep £1billion of incentive payments paid in advance and not fulfilled. NHSE just make up responses on the hoof knowing nobody is holding them to account on general practice. Why don’t they just admit they aren’t bothered?
So total general practice spending went up by 0.8% last year, when inflation was 11%
That’s a huge cut..
Public sector gaslighting to small people where have we heard that before!
Maybe there will be a drama and a public enquiry in 10 years time over the demise of primary care?Roll on April
They can’t control the spend in hospitals – and it seems that they don’t really want to try.
As per the article in today’s HSJ, hospitals were given £1 billion in incentive payments (on top of the funding they were given to deliver those targets), they didn’t hit any of the targets, but they got to keep the money, no questions asked.
Compare this to NHSE and ICB’s hard line approach to inventives and funding in general practice. Can you imagine an ICB saying ‘you missed QOF targets by miles, but have the money anyway LOL’?
We are a soft touch for cuts. And despite this we continue to overperform, and they continue to drive us to work harder and harder, with less and less funding.
Why does this never appear on the front pages !
we continue to overperform, and they continue to drive us to work harder and harder, with less and less funding.
and that’s the problem we overperform for arguably a pay cut 2′ care would never do this
Anybody feel some inflationary spending on healthcare. I can think of a few small prescribing changes that would cost them a fortune. Along with a few extra referrals because you can’t be too careful you know and perhaps a few more tests. Not industrial action but they clearly don’t value our risk sinking of healthcare so we need to stop doing it.
Usual NHSE lies dressed in gobbledegook.
The problem’s not financial but political.
Those thinking about industrial action should consider DJ’s approach.
There is not enough of an appetite for a walk-out type industrial action like junior doctors or consultants. But there are ways to stay within the contract, not harm patients and make a very loud point.
You can start with prescribing decisions which help patients clinically or those struggling with finance. Like:
– Freestyle libre (or similar) for all DM and pre-DM patients (has been shown to improve HbA1c)
– Prescribing medicines which can be bought otc for those struggling to afford them, like paracetamol, emmolient creams etc.
And there would be a massive list they could go through month by month. After that there is the option of very expensive changes to prescribing and referrals:
– no shared care
– DVT/ PE fully managed through the hospital.
– Atorvastatin, Clopidogrel and Sertraline changed to Lipitor/ Plavix/ Lustral. (This one alone is worth many times the primary care budget every single month)