This year's pay deal will see a sharp rise in GMS funding in the north of England and losses in the south, a DoH document has revealed.
A spreadsheet sent to SHAs shows that nine of the 10 PCTs that will increase GMS spending most under the 2009/10 deal are in the north. The other is in the east Midlands.
These areas will see spending on GMS practices increase by between 6 and 10 per cent.
By contrast, all 10 of the PCTs where practices will do worst under the deal are in London and the Thames Valley.
Eight of these will see an absolute fall in practice funding, of up to 1.6 per cent, compared with 2008/9.
Part of the variation can be explained by the fact that core funding increases will vary by between 0.7 and 12.5 per cent, depending on the size of a practice's MPIG correction factor. But changes to the prevalence formula mean that about a third of PCTs are also expected to pay out less on QOF in 2009/10 than the previous year (GP, 17 April).
In London, QOF funding is likely to drop catastrophically thanks to the city's low prevalence.
This means that practices in 28 of London's 31 PCTs will, on average, receive less than the 2.29 per cent national average funding increase, and six will actually lose funding.
Dr Michelle Drage, chief executive of Londonwide LMCs, said she was 'weary of London being at the bottom of the pile when it comes to funding'.
She called for the city's health bodies to work together to 'start making London's case'.
Jon Ford, head of the BMA health policy and economic research unit, said he was 'uncomfortable' with the DoH's assertion that the changes would redirect funding to practices with the highest workloads.
For many practices, correction factors had taken the place of funding streams such as deprivation payments that were lost in the 2004 GMS contract, he said.
'The reason we only agreed a one-year deal is that we don't feel comfortable with the assertion that practices with no correction factors deserve to benefit most,' he added.
|GMS funding winners and losers|
Predicted change in total funding for GMS practices by PCT, 2008/9 to 2009/10: