So it turns out inflation is real

Editor Jaimie Kaffash criticises NHS England’s decision to cut primary care funding at a time when practices are struggling to pay their energy bills

I’ve had to read the paragraph in NHS England’s annual report for 2022/23 a couple of times as it was scarcely believable on first reading. ‘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,’ it said. ‘This required us to reprioritise transformation funding, in particular cutting funding for digital investment and for primary care.’

Unfortunately, NHS England haven’t yet elaborated on this – ie, which projects have been defunded (sorry, I mean reprioritised), what these energy costs related to, etc. But whatever answers we eventually get won’t explain why they feel as though general practice was the obvious place to make cuts.

We know there is a funding crisis. And, as I have said on these pages in the past few weeks, it should provide a sliver of optimism that we can see a path to alleviating the problems in general practice that doesn’t involve magicking GPs out of thin air, and only requires an injection of funding. So why on earth would they remove funding at a time like this?

There is an answer to this, in that they are specifically talking about ‘transformation’ funding. And there is merit to this, because I have never seen a ‘transformation’ project that has made a difference to GPs and patients. But if this is the case (and I think it is), then this funding should have been put into core general practice years ago. Removing it, even from largely pointless projects, is taking away from primary care and giving to – presumably – secondary care to pay their heating bills.

But there is an even bigger issue for me here. We know that the funding crisis – which, lest we forget, is leading to GPs out of work and even redundancies – was in no small part caused by the Government’s insistence to stick with a funding agreement made in 2019, before the cost-of-living crisis was an apple in Liz Truss’s eye. Whereas other parts of the NHS were being given funding increases of around 6% (still not enough), general practice was barely surviving on a 2% increase.

Now, it seems, NHS England have decided that inflation does exist, and these rising energy costs do need to be paid. And general practice is not only being deprived of inflationary increases, but is even having its budget raided to do so.

Next week, GPC England is meeting to discuss the new contract offer. I have no inside knowledge on what it contains, but the absolute silence around it is worrying me. I do have faith that the GPC leadership will take the fight to NHS England (and, maybe more importantly, the Treasury), but this will be a long road and practices will need to keep paying their heating bills in the meantime.

If I were a GPC England negotiator, I would be shoving that paragraph under the noses of NHS England at any opportunity and warn them that if they fail to listen, any goodwill on GPs’ part will also be deprioritised.

Jaimie Kaffash is editor of Pulse. Follow him on X (formerly Twitter) @jkaffash or email him at editor@pulsetoday.co.uk