NHS England’s plans to overhaul core funding allocations to GP practices are ‘not appropriate’, the BMA has warned.
The plans, which could see practice funding cut for out-of-area patients, were intended to promote ‘digital’ primary care models in the ‘biggest GP contract reform since 2004’.
However, the BMA has said the proposals ‘will discourage’ practices from taking up digital models, as long as out-of-area regulations are in place and advised the regulations be withdrawn.
This comes after concerns that Babylon’s GP at Hand model, which now has over 44,000 patients, was destabilising practice income by registering patients to a host practice in London from across the city.
In July, NHS England announced a consultation on changes to practice funding calculations aimed at enabling ‘full adoption’ of ‘digital’ primary care models and mitigating ‘unjustifiable redistribution’ of GP funding.
In addition to reducing practice funding for out-of-area patients, the consultation proposes stricter rules on which patients count towards the London weighting and how the rurality index is calculated.
However, in its response to the consultation, the BMA said the proposals provide ‘a disincentive to other practices in pursuing the digital first model’.
It said: ‘Given the direction of travel for technology and innovation, both generally and within the NHS, the proposals within this consultation are not appropriate.
‘If online access … were made available to all practices on an equal basis, with appropriate resource and without delay, there would likely not be a requirement for these proposals to be made.’
The BMA added that if all practices had equitable access to digital systems, ‘patients would remain with the practice whose boundary they reside within, and simply make use of the online services with their own practice, maintaining their continuity of care’.
Therefore, the BMA said out-of-area regulations ‘should be withdrawn as they are not in line with wider NHS England policy relating to … population-based health management’.
NHS England has long called for practices to cover large populations, with its former primary care director saying GPs should embrace the rollout of ‘primary care networks’, covering 30,000-50,000 patients.
It added that this would not adversely impact patient choice, because ‘patients can already be refused registration if they are not within the boundary’.
The BMA said: ‘These proposals will not support the take up of digital delivery mechanisms, if anything they will discourage them, if the [out-of-area] regulations are retained.’
This comes after Pulse reported today that a 400,000-patient superpractice has partnered with private digital provider Push Doctor to provide video GP consultations to its patients.
Pulse approached NHS England for comment.