CCGs fear they will not have sufficient resources to provide the £1.50 per head for primary care networks (PCNs), the CCG representative body has warned.
NHS Clinical Commissioners (NHSCC) told our sister publication Pulse that some of its members ‘are concerned’ their existing allocations do not go ‘far enough’ to deliver the £1.50 per patient as mandated in the new five-year GP contract.
GP leaders have said this requirement will add additional drain on CCGs that are already grappling with driving up standards while NHS funding ‘suffers an unprecedented squeeze’.
Under the new network contract DES, all PCNs will receive an annual uplift of £1.50 from CCGs’ core funding as an entitlement to cover their general administration costs, such as the remaining 30% of funding needed to fund the additional practice-based roles.
The commissioner body said it is a ‘difficult time’ for CCGs that already have to ‘reduce running costs’ at a time when they are faced with ‘increased financial pressure’.
The Health Foundation previously warned that some practices might struggle more than others to cover the costs of the new clinical roles within PCNs.
Speaking to Pulse, NHSCC co-chair Dr Graham Jackson said he has heard some CCGs expressing concerns about their capacity to ringfence £1.50 per head for the networks in light of ‘spiralling demands, competing priorities and increasing financial pressures’.
He said: ‘The £1.50 per patient uplift for PCNs will be drawn from CCG central funds and is a continuation of the primary care transformation funding originally announced in the GPFV, most of which will flow through the network contract via CCGs.
‘We have heard from our members that some CCGs are concerned that the new funding [to CCGs] doesn’t go far enough. Ensuring patients get the best possible care and outcomes against a backdrop of spiralling demands, competing priorities and increasing financial pressures is one of the biggest challenges CCGs face.’
An NHSCC spokesperson added: ‘CCGs are under increased financial pressure with having to reduce running costs so it is a difficult time for them.’
As set out in the GP Forward View (GPFV), published in 2016, CCGs were allocated a £171m one-off investment – around £3 per patient over two years (2017/18 and 2018/19) – for practice transformational support.
According to the BMA’s PCN handbook, the £1.50 funding for networks is an extension of this investment, which was used ‘in various ways across the country’.
Dr Jackson said: ‘Funding for PCNs is largely a continuation of previous transformation funding as set out in the GPFV, and a number of CCGs may well be able to meet this requirement without difficulty. However, financial pressures on CCGs should not be underestimated, nor should the high expectations for PCNs.
‘Commissioners are facing the considerable challenge of delivering system financial balance whilst reconfiguring local structures and delivering new clinical priorities as set out in the long-term plan. This comes alongside a 20% reduction in running costs, which means that clinical commissioners will have to do more for less, and continue to make difficult decisions to ensure the best value for the patients and local populations they serve.’
Responding to his comments, Tower Hamlets LMC chair Dr Jackie Applebee said: ‘If the Government were really worried about the future of general practice they would not have insisted that the £1.50 per patient uplift for PCNs came out of existing CCG budgets.
‘CCGs are, like the rest of the NHS, struggling to drive up standards while NHS funding suffers an unprecedented squeeze, just like all other public services, under austerity.’
London GP Dr Nick Mann said: ‘An uplift of £1.50 per patient for networks represents 1% uplift on the global sum per patient. The activity required to set up, staff and manage networks and DES requirements, for example extended access, will far exceed 1% in my opinion.
‘Funding for the clinical directors and ancillary staff, except social prescribers, will be a significant extra drain on CCGs – money which needs to be spent on holding services together until the political will exists to fund the NHS sustainably.
NHS England said earlier this month that the networks will have to succeed in convincing a new generation of GPs to go into partnerships or face becoming ‘salaried to other NHS providers’.
This story was first published by our sister publication Pulse.