Exclusive: 'Inadequate' practices face funding double whammy, warns RCGP

Underfunded practices that have received the CQC's lowest rating could struggle to improve because they face significant financial costs to turn themselves around, the RCGP vice chairman has warned.

RCGP vice chairman Dr Tim Ballard: Inadequate practices need funding (Photo: UNP)
RCGP vice chairman Dr Tim Ballard: Inadequate practices need funding (Photo: UNP)

Dr Tim Ballard said practices rated inadequate and placed under the special measures regime by the CQC face additional financial problems due to the costs of trying to improve.

Dr Ballard’s comments came in response to GP exclusive research which revealed that practices given poor ratings by CQC inspections receive below average funding.

Analysis showed that those rated 'inadequate' receive an average of £70,000 a year below national average funding.

Those identified as inadequate and placed in special measures by the CQC are given the option of RCGP assistance to improve. Practices that take up the offer must pay £5,000, while NHS England contributes a further £5,000.

Low GP funding

Dr Ballard said it was difficult to say whether low funding was a cause or an effect of a poor performance. Some inefficient practices are not well-led and fail to claim all the resources they are entitled to because they are not delivering the services, he suggested.

‘The system needs to be acutely aware that to deliver high quality general practice you need to break that cycle,’ Dr Ballard told GP, ‘and that if you have practices that historically have become underfunded, then we get involved with them to give help and support as part of the RCGP special measures programme, then the resources need to come from somewhere.’

Dr Ballard contrasted the approach in general practice with that in secondary care where rather than take money from the best performers to fund the worst, services are levelled up with additional help.

Being placed into special measures ‘brings with it financial challenges’, said Dr Ballard, such as additional hours for practice managers.

GP locum fees

‘There are anecdotal reports of locums wanting to to be paid more to work in practices in special measures,’ added Dr Ballard. ‘So not only are a lot of these practices struggling financially, and end up with low performance marks from the CQC, their ongoing financial performance is challenged by the process itself.’

Dr Ballard said: ‘It seems it would be helpful for resources to be available, if the system wants these practices which have been identified by the CQC to turn themselves around, with help and support from LMCs, from us and ... local area teams, it seems it would be a wise thing to do to invest in that.’

It would be helpful, added Dr Ballard, if CQC inspectors could provide funding context in their inspection reports to improve understanding for CCGs and NHS England.

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