By Gareth Iacobucci
GPs need greater incentives to work in deprived areas in order to tackle health inequalities, according to a report by the National Audit Office.
The report, which found that the life expectancy gap between rich and poor people in England is widening, despite concerted attempts by the previous Government to tackle health inequalities, said the Quality and Outcomes Framework ‘does not provide enough of an incentive to target GPs’ attention on the neediest groups’.
It said that GPs have been able to achieve full QOF payments without covering the entire practice population and ‘as a result the hardest to reach and most in need groups may not be helped through this framework’.
It added that areas with high disease prevalence have historically received less remuneration per patient than those with low prevalence, meaning that until the system was changed in 2009, ‘payments to practices did not fully reflect the level of illness in the practice population’.
But it said new incentives announced by the Government, should mean that by 2011, ‘payments are expected to fully reflect the level of need with consequent redistribution of payments between practices’.
Health minister Earl Howe announced last week that the Government is to radically reshape GP funding by redirecting cash to GP commissioning groups in the most deprived areas, although full details have yet to be released.
The report found that average life expectancy across the whole population is 77.9 years for men and 82 years for women, but in the most deprived areas – covering 28 percent of the population – the figure is lower at 75.8 and 80.4 years.
It also reported that the gap between the two increased by 7% for males and 14% for females between 1995-97 and 2006-8.
The NAO did acknowledge that the Department of Health had made a ‘serious’ attempt to tackle health inequalities across England, but said there was no evidence so far that the approach from 2000 onwards had provided value for money.
It said the government’s target of reducing the health inequalities gap by 10 percent by 2010, as measured by life expectancy at birth, will not be met if current trends continue.
Amyas Morse, head of the National Audit Office, said: ‘The Department of Health has made a concerted effort to tackle a very difficult and long-standing problem.’
‘However, it was slow to take action and health inequalities were not a top priority for the NHS until 2006. We recognize that this is a very complicated issue and that it took time to develop an evidence base. However, the best, cost-effective interventions have been identified and now must be employed on a larger scale in order to have a greater impact and improve value for money.’
‘The Department should target its efforts on the most deprived areas of the country and develop costed proposals to maintain or increase investment in preventative interventions to tackle the conditions which lead to health inequalities.’
Greater funding is needed for practices in deprived areas, the NAO report said Greater funding is needed for practices in deprived areas, the NAO report said