Exclusive GP practices are in some areas being expected to work with their clinical commissioning group (CCG) for free amid claims failure to reimburse GPs properly for their time was undermining engagement.
A Pulse investigation reveals GPs in some areas are either going unpaid or receiving as little as 10p patient this financial year – not enough to cover time spent out of practice. There is sharp variation in how GPs are being funded for commissioning activity, with some practices paid almost £4 per patient.
The figures come after last week's investigation showed very few GP board members of CCGs had faced a contested election, amid claims of ‘widespread apathy' over commissioning among grassroots GPs.
PCTs provided comparable figures via a Freedom of Information Act request for 42 CCGs on commissioning payments to practices. Of these the average during the 2011/2 financial year was £1.74.
But NHS Stockport said payments to practices ‘will only be those paid via QOF', while NHS Brighton and Hove said ‘funding has not yet been identified' and NHS Calderdale said funding had ‘not been agreed yet'.
NHS Oxfordshire is funding practices £333,967 in total, equating to ‘£3,210 per practice with £0.10 per patient' and covering ‘clinical participation at not less than eight locality commissioning meetings in 2011/12 '.
Elsewhere, NHS North Staffordshire said: ‘Practices will receive £0.50 per patient for representation at all meetings, with practices smaller than 4,000 patients receiving a flat payment of £2,000 per annum.'
Other groups are funding GPs significantly more. NHS Peterborough said: ‘Each cluster member practice will receive a total amount of £3.90 per registered patient on sign-up to formal accountability agreement.'
The Kirby and Knowsley South Health groups on Merseyside are funding GPs ‘£3 per patient to support clinical engagement' with payment ‘dependent upon practices providing evidence of participation'.
Our investigation also showed variation in money paid to GPs on CCG boards. Of 48 CCGs where the hourly rate was given for board members, including chairs, the average was £79, ranging from £66 to £90.
GPC negotiator Dr Chaand Nagpaul said clinical commissioning ‘would not succeed if GPs don't have the resources to be engaged'.
He said: ‘We've seen examples of practices expected to turn up to meetings without being adequately funded. We have to remember, the success of CCGs is entirely dependent on sign-up of GPs.'
Dr Nigel Watson, chair of the GPC's commissioning and service development subcommittee, and a GP in the New Forest, said: ‘Why would a practice release you for three days a week if the funding doesn't even cover your time away?'
How practices are being funded for commissioning
- Peterborough - £3.90 per registered patient
- Kirby and Knowsley South Health groups, Merseyside - £3 per patient
- Ashford CCG, Kent - £2.92 per patient
- Leeds Leodis and Calibre - £2.36 per patient
- NHS Stockport - £0
- NHS Brighton and Hove - £0
- NHS Calderdale - £0
- Oxfordshire - £0.10 per patient
- North Staffordshire - £0.50 per patient
- Halton and St Helens, StHealth CCG – £0.95 per patient
Source: Requests under the Freedom of Information Act