GP budget holding should be 'prize' for best practices

GP budget holding must not be promoted as a universal solution and there must be 'careful selection' of participating practices, according to a report by the recently appointed King's Fund chief executive.

Prof Ham: present GP fundholding as a prize
Prof Ham: present GP fundholding as a prize

The report, which is part of Professor Chris Ham's later work at the University of Birmingham, outlines that many GPs will be reluctant to sign up to fundholding.

It suggests that one way of addressing this would be for policy makers to ‘present GP fundholding as a prize' to be offered to practices that are willing to take on the role, rather than expecting all practices to be involved from the start.

It said: ‘This would appeal to the natural competitiveness of GPs. Seeing GP budget holding as a reward for proven competence might provide the motivation that has been lacking in GP commissioning in the recent past.'

The report also said that the size and the scope of budget holding needs careful thought, and it is unlikely that a one size will fit all needs.

‘Budget holding should be implemented for both smaller and larger groupings with the scope of budgets being adjusted accordingly,' the report said.

It also outlined that GP leadership and management expertise will be critical to the success of budget holding.

The report concluded: ‘Like many other health policy initiatives, GP budget holding holds promise and is an idea worth taking forward, but the devil is in the detail.

‘In view of the complexities involved, a strong argument can be made for piloting and evaluation in advance of widespread implementation.'

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