Exclusive: One third of PCTs diverting GMS pay

More than a third of PCTs have failed to spend their share of a £50 million investment package meant for practices as part of the 2008/9 pay deal, a GP investigation has revealed.

Dr Nigel Watson: PCTs do not have enough money for everything — so half of it gets forgotten about
Dr Nigel Watson: PCTs do not have enough money for everything — so half of it gets forgotten about

Other PCTs admitted diverting the funding to pay for GP-led health centres and balanced scorecards.

In March 2008, the GPC accepted a contract deal with a 'guaranteed 1.5 per cent investment in general practice', worth £105 million. From this, £50 million would go towards new clinical enhanced services, £5 million into the global sum, and £50 million could be used by PCTs to 'improve access and responsiveness in GP services'.

In September 2008 Mark Britnell, then NHS director general of commissioning, wrote to PCTs instructing them to use the £50 million access cash to raise local enhanced service (LES) spending by 20 per cent.

But of 65 PCTs to respond to a Freedom of Information Act request by GP, just half spent the money on LESs. A third (36 per cent) had not invested the cash in primary care services and 43 per cent could not provide a conclusive breakdown of how the money was spent.

Seven PCTs used the cash to fund GP-led health centres and two spent it on developing balanced scorecards to performance manage GPs. The majority of PCTs that had spent their allocation used it to offset the cost of extended hours.

A further seven PCTs could find no record of even receiving any of the £50 million.

GPC deputy chairman Dr Richard Vautrey said few practices have seen evidence of investment that would improve services for patients. He said the GPC was 'well used to money not being ring-fenced and therefore being spent in other ways, often to fund deficits in other PCT budgets'. The GPC 'is in dialogue' with the DoH about recovering the money.

Dr Nigel Watson, chief executive of Wessex LMCs, said just 'two or three' of the eight PCTs in his region definitely invested additional funds into LESs.

'I think it's scandalous. What happens is PCTs have a list of 'to dos', 'must dos' and 'must, must dos' and they do not have enough money for all of it - so half of it gets forgotten about.'

David Stout, director of the NHS Confederation's PCT network, said LES spending rose from £251 million in 2007/8 to £323 million in 2008/9.

'It is the way PCTs receive their allocations. Cash for the GP deal is not ring-fenced. But in terms of what has been spent there has been more investment than mentioned in the deal.'

A DoH spokesman said that it was 'for PCTs and practices to decide' how to use the additional £50m investment.

A spokesman said that PCTs were given £120m to spend on GP-led health centres, but may have used other funds to provide 'additional services' at the clinics.

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