The Government has launched a six-month review of the model used for allocating GP funding, to try and tackle health inequalities.
The Carr Hill formula, which was initially introduced in 2004, has been widely criticised for not considering deprivation factors, as it focused more on factors influencing patient needs and costs.
Research from the Health Foundation has suggested that practices that serve more deprived areas of the country receive nearly 10% less funding per patient than those in affluent areas.
The review, launching today (9 October), will look to identify a new funding formula, assess the impact and feasibility of implementing it, as well as ensuring it aligns with the 10 year plan.
The Department of Health and Social Care (DHSC) gave the example of Leicester, Leicestershire and Rutland (LLR) ICB, which calculated funding requirements based on the need of the population rather than workload.
It found there was a ‘vast disparity’ in distribution, with one in five practices receiving 10% too little or too much funding, and one in 15 facing 15% too much or little.
The practices that had a shortfall were in the most deprived areas, the DHSC added.
Ahead of his attendance at the RCGP conference today, where he is expected to announce the review, primary care minster Stephen Kinnock said: ‘The way GP funding is allocated is outdated and no longer fit-for-purpose – with more deprived areas and coastal communities across the country experiencing the highest levels of inequality.
‘With GPs at the heart of our 10-Year Health Plan, it is vital that we don’t leave any community behind and that we end the postcode lottery of care.
‘As we invest in primary care – we must prioritise the areas and communities which have the most need to drive health improvements and close the gap on these health disparities.’
NHS England national director for primary care Dr Amanda Doyle said: ‘It is essential that GP practices serving our most deprived communities, where health challenges are often greatest, receive a fair share of resources that reflects their need.
‘By overhauling GP funding for the first time in two decades, the NHS can better help people to get the support they need as GPs and their teams deliver record numbers of appointments for their communities.’
Nuffield Trust deputy director of research Sarah Scobie said the Government deserves ‘real credit’ for talking this inequity.
‘The current “Carr-Hill” funding formula is outdated and reinforces the unfair reality that people in poorer areas get poorer healthcare. If implemented successfully, this approach could also help with the government’s aim to shift the focus of healthcare from treatment to prevention,’ she said.
‘But such reform will need to come with additional funding and will require a concerted effort across government and the GP profession to ensure that some areas don’t lose out as cash is redistributed.’
Luisa Pettigrew, senior policy fellow at the Health Foundation, said the review was a ‘welcome step’.
‘The review should look at the range of funding sources going into general practice, how this money is best used, and the extra investment needed to avoid patients in some areas losing out,’ she said.
However, she added that making this happen will depend on additional funding going into general practice and not removing it from one area to another, ‘or relying on savings from hospitals which may never materialise’.
‘This is not the first time that general practice funding has been reviewed – the real test for government is whether they follow it up with the policy change and investment needed in response.’
RCGP chair Professor Kamila Hawthorne added: ‘A patient’s postcode and where they live should not determine the level of NHS care they receive. It can’t be right that people in deprived communities – who often have more complex health needs and would therefore potentially benefit from health interventions most – are less likely to receive it, because GPs in deprived areas are responsible for hundreds more patients per head on average than those practising in more affluent areas.’
Last month, health secretary Wes Streeting said he would ‘work with’ GPs on reforms to the Carr Hill formula in order to avoid ‘unintended consequences’. The 10 year plan had also previously committed to reviewing Carr Hill.
A major report by Healthcare Leader and its publishers also called for reform to the Carr Hill funding formula to be done urgently.
