Streeting to work with GPs to avoid Carr-Hill reform ‘unintended consequences’

Health secretary Wes Streeting has said he will ‘work with’ GPs on the planned overhaul to the Carr-Hill formula for weighting GP funding.

Speaking to the BMA’s special representative meeting on the 10-year plan on Sunday, Mr Streeting said this was necessary to avoid ‘unintended consequences’.

In the same discussion, he also denied that his planned neighbourhood health centres are a repeat of the Darzi centre experiment from 15 years ago.

The health secretary was responding to a question about neighbourhood health centres when he mentioned the planned reforms to the Carr-Hill GP allocations formula.

In a Q&A with BMA chair Dr Tom Dolphin, Mr Streeting was asked to explain why he thinks the neighbourhood health centres will succeed when polyclinics – or Darzi centres – did not.

To which he responded: ‘The first thing just to say is we’re not going back to the future here on polyclinics. What we are doing is a radically different approach on neighbourhood health, both in terms of substance and design.’

He went on to stress the importance of the ‘left shift’ for the NHS – a term used to refer to moving care out of hospital and into the community’

Mr Streeting said: ‘So you’ll have already got a sense of the extent to which we are prioritising general practice, in terms of the extra billion pounds that we put in the contract reform, the reform to ARRS – I don’t pretend for a moment that that kind of just washes the problems away. There is still much more to do, but the starting point is that recognition that unless we genuinely deliver on the left shift, we are going to continue to have an inefficient and ineffective system that diagnoses far too late, leading to higher costs of treatment, poor outcomes and higher costs the taxpayer.

‘So as far as I’m concerned, the left shift is absolutely mission critical, for patient, for taxpayer, for doctors, for the sustainability of the system. And linked to that, we’re also reforming the Carr-Hill formula to put a greater emphasis on deprivation-linked funding. And we’ll be working with you on that, not least to make sure we don’t end up with unintended consequences.’

Several governments have attempted to reform the Carr-Hill formula, which weights funding based on factors such as age and disease prevalence, to better take into account deprivation. The Labour Government’s attempt at doing so was announced in June as a preview to the 10-year plan for health.

The health secretary previously told MPs that the Government ‘will consult’ on Carr-Hill reform, but DHSC has confirmed to Pulse that there won’t be a public consultation, only ‘key stakeholders’ will be asked for their opinion.

The review will look at how health needs are reflected in the distribution of funding through the GP contract, ‘drawing on evidence and advice from experts’ such as The Advisory Committee on Resource Allocation (ACRA), and ‘in consultation’ with the BMA GP Committee, the Government said.

Doctors leaders have told Pulse that it is ‘essential’ that any changes to the Carr-Hill formula are accompanied by an overall increase in funding for general practice, as simply redistributing a fixed pot of funding risks creating new pressures in other areas.