GPs welcomed the increase of funding announced in the GP Forward View, but have demanded that more must be done to improve GP care, in a debate on funding at the LMCs annual conference 2016 in London.
Introducing the debate, GPC deputy chairman Dr Richard Vautrey said it was unacceptable that the UK is one of the richest countries but funding remains so low.
The GPC will push hard to ensure the £2.4bn funding promised in the GP Forward View is delivered to practices as soon as possible, he added, arguing that general practice needs £2.5bn now just to fill the current gaps in funding.
‘We need that funding to plug the gaps as soon as possible. But the GP Forward View promises this will take four years. Promises of jam tomorrow will not help practices who need bread today.’
Delegates called on the GPC to further push for GPs to have an activity-based contract, which GPs voted in favour of at last year’s LMC conference.
Dr Jim Kelly, who famously channelled Elvis Presley while calling for an activity-based contract at the 2014 LMC conference, called for the GPC to take firmer action.
‘Last year you voted for an activity based contract,’ he said. ‘That's the only thing that will future-proof our profession. We need to be paid for the work we actually do.
‘We need A little less conversation, a little more action, please. The GPC’s reaction [to last year’ motion] was to produce a discussion paper – but now we need action.’
Dr Gaurav Gupta from Kent LMC backed the call. ‘New GPs don’t want to be partners, why is that? Because they are smart. They don’t want to commit themselves to something that's underfunded and unsustainable.
‘We need more money for core work. Maybe it’s time for an activity-based contract – that could be our only solution.’
Dr Vautrey said: ‘We need to recognise that we did some work on the activity based issue. But NHS commissioners are not the slightest bit interested in discussing that with us.’
GPs also called for the Car-Hill formula to be replaced, but stressed that extra funding does need to be allocated to practices in deprived areas.
Dr Grant Ingrams said funding needed to be rebalanced to recognise workloads. ‘I moved to a leafy suburb in Leicester from a deprived area in Coventry – my income went up and my workload went down. The Car-Hill formula needs to be redone, but deprivation needs to be taken into account.’
Dr Naureen Bhatti, from London, also called for practices in deprived areas to receive better funding.
‘We have a postcode lottery due to inept distribution of inadequate funds,’ she said. ‘We need a levelling up with recognition of everyone’s workload. We are the fourth richest country in the world – we can afford this.’
But Dr Vautrey cautioned GPs calling for the Car-Hill formula to be scrapped. ‘We need to be careful about the Car-Hill formula – conference asks for this to be removed, but there will be winners and losers even with most perfect formula.’
He added: ‘Car-Hill has to be addressed, deprivation has to be recognised – but not at the expense of everyone else.’
Dr Alex Freeman from Isle of Wight LMC said: ‘I've heard calls for the Car-Hill to be renewed – my view is you can put glitter on it, but a turd is still a turd.’
Increase core funding
Calls for core GP funding to be increased were also high on the agenda. Derbyshire LMC’s Dr Peter Williams said increased funding would help drive up quality of care and thereby save costs in the long run.
He said: ‘I want to give a case study of one. CQC said our practice was outstanding in every area. We have one GP for every 1000 patients, our prescribing is on budget. How have we done this?
‘We invested our own money to do it. That means we have 25% extra than normal practices – we have 10% when everyone else is on 8%. If core funding was put back to 11/12%, every practice could do that. We need to invest so that general practice will be able to save the NHS.’
Dr Jeremy Luke from West Sussex LMC said: ‘Every piece of work pushed into general practice should come funded. We've got to make sure everyone stands firm and supports us on this. Do not send us work unless you send the funding.’
Delegates voted that they largely agreed with the GPC’s current policy on funding, with most voting ‘5’ out of a scale from 1 ‘not at all’ to 6 ‘completely’.