Details of final quality premium bonus payouts for 2014/15 show commissioners have been awarded just over a quarter of the £272m available. CCGs will receive a total of just £73m, official data released at the end of December reveal.
CCGs have said that much or all of the premium funding they receive would be directed at improving primary care, meaning practices could miss out on up to £380m over the two years.
For 2014/15, a total of 22 CCGs out of 211 received no quality premium award, down from 28 who received nothing for 2013/14.
The quality premium is awarded by NHS England to reflect improvements in the quality of services CCGs commission.
CCGs were not eligible for premium funding if they were in deficit at the close of the financial year, if they are considered to have mismanaged funds or where there is a serious quality failure.
GP leaders have opposed the quality premium scheme and have repeatedly called for the full amount to be put into CCGs' core funding for spending on patient services.
Commissioning groups are awarded premium cash according to six measures covering national and local priorities, including reducing years of life lost through causes amenable to healthcare, reducing premature mortality, improving access to psychological therapy, reducing avoidable emergency admissions, addressing issues identified by the Friends and Families Test, supporting roll out of the test and improving reporting of medication related safety incidents.
Each priority measure is worth a percentage of the CCG’s maximum award which is calculated at £5 per head of population.
Primary care outcomes
CCGs must use the funding awarded to improve quality of care or health outcomes and to reduce health inequalities. Much of the awarded money is expected to go into primary care.
Last year several CCGs told GPonline they expected to spend most or all of the funding in primary care.
The CCG awarded the highest proportion of the available premium funding was Crawley, which achieved 85% of the available pot. Brighton and Hove, West Kent and Newbury and District all achieved 75%.
GPC deputy chairman Dr Richard Vautrey said: 'We have always objected to the quality premium scheme which has consistently denied much needed resources to CCGs and therefore practices. Setting arbitrary targets that can often not be met despite best efforts is no way to enable local areas make the most of scarce NHS funds and will be seen by many as a central cost-saving exercise rather than a true way of investing in quality services.
'It's time we saw a real central commitment to address the underinvestment in general practice and an end to schemes like this that not only don't work but also compound problems.'