Speaking to GPonline, NHS England’s head of general practice development Dr Robert Varnam admitted that the first year of the vulnerable practice scheme had been ‘very disappointing’ in much of the country, but he said money and support were now getting through to practices.
The RCGP heavily criticised progress on delivering the practice resilience programme at the start of this year. A college report on the GP Forward View found that by the end of 2016 just £2.5m of that year’s £16m practice resilience fund had been spent, which it said was ‘extremely disappointing’.
However, in a BMA report in April NHS England reported that £17.2m of the GP resilience programme funding had been spent on 1,279 practices by the end of March 2017. NHS England also reported spending £10.1m through the vulnerable practices programme, against a commitment of £10m.
Dr Varnam said progress had been slow because ‘of the time it took for people to agree their plans and the hard stop of the end of the financial year meant people were racing to come up with plans.’
He added that there had also been problems because the scheme was completely new, which meant it took people ‘longer to get their head around it, agree a plan and sign up for a plan’.
Savvy spending decisions
Dr Varnam said he had been encouraged to see that most practices were making ‘some pretty savvy decisions about what to spend the money on’.
‘When the idea was announced there were some concerns expressed that people might use this as a short-term sticking plaster solution – use all their money to get extra nursing or GP time to fill a gap and they might not think beyond a few months,’ Dr Varnam said.
He said that some small practices hit by long-term sickness had used the funding to cover staff absence and, for them, it had made a real difference.
However he added that many practices were discussing their plans with neighbouring practices or their LMCs to work out how they could best use the funding to become more sustainable and ensure they did not end up in a vulnerable position again.
‘The big areas practices have been investing in are diagnostics,’ Dr Varnam said. ‘So getting an expert to measure their caseload and look at how much of it GPs are seeing that could be seen by someone else. Or looking at how much a practice individually spends on recruitment or accountancy, or how much time a month is being spent on payroll – areas where practices could collaborate to instantly free up some time.
‘It’s really great to see that people are saying we need urgent help to be more resilient and, if someone is going to give us money, let’s use that to do things differently. Let’s use that to do a better job by working differently together.’