In the first debate at the LMC conference 2017 in Edinburgh, Kent GP Dr Jim Kelly told delegates that the Carr-Hill funding formula was 'a joke' and implored the profession to get rid of it. Summing up at the end of the debate, he reiterated his message in song - breaking into a version of Ed Sheeran's Shape of You to urge LMCs to vote for funding reforms.
GPs voted strongly in favour of a Kent LMC motion that said: 'That conference believes that core GP funding continues to be under resourced and the current funding formula is not fit for purpose on the grounds that it does not adequately reflect the exponential increase in demand and activity in core primary care.'
Dr Kelly pointed out that CCGs were already being funded under an updated formula. 'Why the delay on passing that on to practice level?'
LMC member Dr Peter Williams said he had told the LMCs conference two years ago that general practice needed 'a bigger cake' - total funding needed to be 150% of the level at that time.
He said that his practice had been rated outstanding by the CQC, was a training practice working closely with a community hospital, and had been adept at bringing in additional funding by hitting targets and delivering enhanced services.
But he told the conference that 'wind forward two years' and the practice felt under intense pressure, with QOF eroded, but all the work still being done and workload across the board rising.
Practices probably needed 200% of what they were getting a couple of years ago, he warned.
'This is not something we need in five years, we need this now. Not doing so will mean more practices will fold, GPs will burn out and patients will suffer. Let's have properly funded general practice.'
Hampshire and Isle of Wight LMC member Dr Andrew Paterson warned that the current funding formula completely failed to recognise the workload involved for practices caring for large numbers of patients in nursing homes.
Weighting for nursing home patients may have reflected workload when the contract was set up in 2004, he said, but since then nursing homes had taken on a role as 'hospital step-down beds'.
'These patients are usually unknown to us and require intensive support,' he said. This extra workload needed to be reflected in practice funding, he warned. 'Support and think about practices with large numbers of nursing home patients being worked to the bone on this area,' he said.
GPC chair Dr Chaand Nagpaul told the conference: 'A review of the formula is already underway, NHS England is looking at that. We need a bigger pot of money, but you also need to address a formula that doesn't make sense. It takes no account of the significant amounts of fixed cost that all practices face. Unless you increase the quantum, another formula will simply create new losers. We are working hard but don't want to destabilise any practice.'