GPs could miss out on £1bn premises cash despite overall funding rise

A £1bn investment fund for primary care premises will target new 'multispecialty community provider' organisations, NHS England has revealed, but all practices could benefit from rising investment in frontline services.

Funding: GPs could miss out on premises cash (Photo: JH Lancy)
Funding: GPs could miss out on premises cash (Photo: JH Lancy)

GP leaders have warned that NHS England must ensure new premises investment benefits existing GP practices, but the £1bn 'infrastructure fund' announced by the government earlier this month looks set to target only providers involved in new provider models outlined in NHS England’s Five Year Forward View.

However, an overall rise in primary care funding from 2015/16 could benefit all practices. An NHS England board meeting today heard that total primary care funding will increase by 4.1% next year to £12.8bn, more than double the anticipated increase. Funding for 'local primary care service commissioning' will rise 2.3%, 0.6% more than planned.

Chief executive Simon Stevens told the NHS England board on Wednesday that additional funding worth £1.98bn for the NHS in 2015/16 would deliver 1.6% real terms growth for next year in the overall health service budget.

Of the new investment, he said, £1.5bn would go to front-line services including general practice. A further £480m next year will go to transformation: split between £200m for new care models, £30m a year for five years for mental health services, and £250m as part of the four-year £1bn fund to 'support out of hospital and primary care transformation'.

Planning guidance

The board said new planning guidance to be published later this month would ‘begin to outline the approach for targeting the £250m infrastructure fund at multi-speciality community providers’.

That funding will be allocated to commissioning teams according to merit of individual infrastructure schemes. The balance between capital and revenue funding requirements will be flexible.

A separate £200m fund for 2015/16, available to all subject to a prioritisation process, will support the creation of new care models and could also benefit primary care. It will be used to pump-prime test sites to promote transformation in line with new models described in the Five Year Forward View.

Setting out spending allocations for the financial year ahead NHS England said that for the first time in recent years total funding growth for primary care would be in line with other local services.

GP campaign success

GPC deputy chairman Dr Richard Vautrey welcomed that announcement as an admission the BMA had been right to campaign against the fall in relative NHS spending on general practice, but warned that CCGs must ensure that funding increases are ‘actually spent in general practice and not used to cover deficits elsewhere in their budgets’.

Mr Stevens added: ‘We are all acutely aware of the importance of proper investment in primary care which has lost out, relatively speaking over the last 10 or 15 years. 

‘So the proposal before the board today is that primary care would get a higher uplift than local hospital and community services. About 20% proportionality higher than what is otherwise allocated across the piece, partly because of the £250m additional funding for primary care infrastructure and out of hospital services.’

NHS England chief financial officer Paul Baumann said: ‘We have increased the amount of core funding growth going into primary care: not the strategic infrastructure funds, but the amount for day-in-day-out commissioning of primary care. Doubtless not by as much as we would want to increase it, but ... it is substantially increased so that all primary care organisations will see an improvement in their financial resources, which I think is necessary to recognise some of the significant pressures in primary care.’

Funding growth doubled

Growth of total primary care funding had more than doubled, he added. ‘In the proposals last year, primary care was going to get 1.6% growth this year. What is happening in these proposals is that inclusive of all these investment funds there will be 4.1% growth ... including an increase in underlying funding.’ 

Dr Vautrey said the core message of increased funding for general practice was ‘welcome and long overdue’.

‘We are finally winning the argument that the previous policy of reducing funding for general practice was a mistake and has led us to the current crisis we are now having to deal with.’

‘However for practices to be able to genuinely develop in the way we know many want to, they need long-term and significant funding increases rather than short term fixes.’

The GPC would, he said, ‘be working closely with NHS England to agree how best the infrastructure fund and support for new models will work to ensure it is used appropriately and effectively.’

Announcing the plans earlier this month health secretary Jeremy Hunt said the new primary care investment should be used to provide specialist care services in the community and to link GPs with job centres.

The autumn statement book said later the money would be used to build new premises to provide advanced, specialist treatments such as chemotherapy and dialysis in the community.

Speaking to GP last week GPC chairman Dr Chaand Nagpaul said: ‘It is highly disappointing that there is a conflation of expanded service provision with what should be about infrastructure and I have responded to this immediately and have already been in dialogue with NHS England.’ 

He added: ‘I believe, looking closely at the wording, we need to go back to government to understand what they mean. I think they were referring to, I believe, they were conflating new models of care with the infrastructure costs. I have gone back to NHS England and I'm told this money is for infrastructure.’

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