Primary care in deprived areas is suffering the most with workforce issues, a report carried out by our publisher Cogora has shown.
The report, called the Cogora General Practice Workforce White Paper, looked at why general practice is facing simultaneous recruitment and unemployment problems, and how to solve both.
It found that practices in more affluent areas have a higher number of GPs and clinical staff per patient than those in the most deprived areas. And that it is ‘well established’ that patients in a more deprived areas are more likely to have higher health needs. But that those in deprived areas receive less income.
The report analysed data on every GP practice in England, using Cogora’s ‘Data Dashboard’ tool.
It found that the practices with the top 20% most affluent patient populations received £137.17 per patient (not including premises costs), and those with the 20% most deprived patient populations got £135.93 per patient.
It said: ‘Because despite these extra health needs, deprived practices do not necessarily get paid more – and, in many cases, their deprivation leads to lower funding.
‘The Carr-Hill formula was introduced in 2004 to calculate how much practices would receive per patient in the form of the ‘global sum’ – this forms the bulk of a practice’s income. The formula is based on patient age and sex, list turnover, rurality and ‘staff market forces factor’, which is based on geographical variations in staff costs.
‘Deprivation is not an explicit factor. There is another element – ‘additional needs of patients’ – which looks at mortality and illness before the age of 65 and does, to an extent, benefit deprived practices. But these additional needs are based on data from before 2000. As deprived practices tend to have younger populations, they often end up with lower-than-average global sums.’
The report added that there are often recruitment issues in more deprived areas, where they need to pay more to attract staff, and called for practices in these areas to receive a ‘greater share’ of funding.
One GP in Leicester said in the report: ‘I think it has been forgotten that the inner city is a completely different world to the suburbs. Certainly in our region, inner-city practices often have to offer higher salaries to attract staff like practice nurses, pharmacists and GPs.
‘Hence there is less funding for other aspects and these higher-funded staff may in some cases be less committed to long-term improvements of inner-city practices.’
The report also surveyed the 42 ICBs on what they are doing for the general practice workforce in their area.
North East and North Cumbria ICB said they have a £35m three-year plan to improve health in deprived areas and to attract and retain more GPs.
Others reported focusing on training hubs and the additional roles reimbursement scheme (ARRS) as a way of supporting primary care.
The white paper has been released by the publishers of Healthcare Leader, Cogora, on the changing general practice workforce in England, in conjunction with the Rebuild General Practice campaign group. Alongside our sister titles – Pulse, Pulse PCN, Management in Practice, Nursing in Practice and The Pharmacist – we have surveyed around 2,500 general practice professionals, interviewed more than 100 frontline practitioners, analysed hundreds of data for every practice in England and brought together all the editorial expertise within our titles.
The white paper was launched at a Parliamentary event last week, which was attended by MPs, GP, nursing, pharmacy and practice manager leaders, and numerous frontline GPs.
Download our General Practice Workforce White Paper here.
