The Health Service Journal revealed on Thursday that NHS England has written to commissioners telling them that all of the 1% of their budgets which had been set aside to mitigate financial risk must be used to offset deficits.
The BMA has called the decision 'scandalous', while the RCGP warned that it 'made no sense' to deny funding to primary care services simply to apply a 'sticking plaster' solution to hospital deficits.
NHS commissioners were told at the beginning on the financial year to set aside 1% non-recurrent spend of their budgets to create a headroom fund of around £800m. Commissioners have only been allowed to access the funds with Treasury approval.
NHS England chief executive Simon Stevens told NHS leaders in June the contingency fund ‘would have been available from CCGs for mental health services, community health services, primary care and other things’.
‘We want to be able to release that funding, and spend on mental health services and community services, so our delivery on these control totals will have a direct impact on our ability to free up that incremental spending for the priorities that we know we have got to resource,' said Mr Stevens.
The 1% of budgets will now be released into commissioners’ bottom line to offset deficits, mostly those of provider trusts, within sustainability and transformation plan (STP) footprint areas.
The risk-pooling measure was imposed by the Treasury at the beginning of 2016/17 to provide stability within transformation areas and a sound foundation for STP implementation.
RCGP chair professor Helen Stokes-Lampard said that yet again funding needed to support general practice and frontline care was ‘being taken away and used to plug hospital deficits’.
‘It makes no sense to take funding away from GP services, and instead use it in a way that will only serve as a sticking-plaster solution to an ongoing problem’, she said.
BMA chair Dr Mark Porter called the decision by NHS England ‘scandalous’ at a time when the NHS is ‘at breaking point’.
‘The NHS is clearly underfunded and services are unable to keep up with rising demand, but instead of addressing this the government has chosen more stopgaps and accounting tricks over providing good services for patients in desperate need’, he said.
‘Taking funding from mental health, community and primary care to prop up deliberately created deficits will do nothing about the fact that most NHS trusts are in the red, our GPs are struggling to meet rising demand with inadequate resources, our hospitals don’t have enough beds and patients are waiting longer for essential care.’
An NHS England spokesman said: ‘As we’ve been saying since the start of the year, we set aside £800m to cover provider deficits if needed, and we do now need to. This is uncommitted money that would otherwise have been invested at the discretion of commissioners. It will be important to get the trust deficit down next year so planned investments can take place.’