GP funding needs to be urgently reformed to address health inequality

Health organisations have joined forces to demand reform of the Carr-Hill formula, which has been used to allocate core GP funding since 2004, as it currently does not equitably distribute funds.

The Royal College of General Practitioners (RCGP), The Health Foundation, NHS Confederation’s Primary Care Network and National Voices have today sent a joint letter  to the Department of Health and Social Care asking for investment and reform so that GPs can address the cost-of-living crisis with patients.

In recent years, according to the RCGP, GPs have increasingly been asked for support by patients with non-medical items including access to council services and financial advice. However, the way general practice is funded means that typically practices in the areas of greatest deprivation have patients with more complex needs, yet don’t receive proportional funding to address those additional needs.

The letter added that practices in the poorest areas have 14.4% more patients per fully qualified GP than practices in wealthy areas, yet receive 7% less funding after accounting for the additional needs of their local populations.

Review GP funding structures for vulnerable patients

Professor Kamila Hawthorne, Chair of the Royal College of GPs said: “GPs have seen the gap between our richest and poorest patients’ health widen over recent years. We have seen the devastating health effects that poverty and deprivation are having on them made worse by the ongoing cost of living crisis – GPs are reporting that they are spending more time dealing with issues that are directly linked to poverty such as obesity, drug and alcohol misuse and mental health conditions like depression and anxiety.

“We need to review our funding structures to ensure that the communities worst affected by rising rates of deprivation get the support they need. Currently, we’re failing to allocate resources appropriately and our most vulnerable patients are bearing the brunt. GPs and their teams across the country are dealing with intense resource and workforce pressures – but this is being felt more acutely in more economically deprived areas. Where people live shouldn’t dictate the care they have access to and receive.”

The RCGP’s latest polling revealed public support for this change, with 71% of the public agreeing that general practices in the worst-off areas should receive additional, targeted funding to help them meet higher levels of patient need.

Practices in areas with the highest levels of income deprivation have on average 300 more patients per fully qualified GP than practices with the lowest levels of income deprivation. This is set against a backdrop of significant national pressures on general practice – on average a fully-qualified, full time GP is responsible for 2,295 patients, 260 more than they were six years ago.

The joint letter is also calling for dedicated investment in workforce expansion programmes that better support and incentivise both new and experienced GPs to work in under-doctored and socioeconomically deprived areas.

Aruna Garcea, Primary Care Network, NHS Confederation, said: “Health leaders know that a well-funded NHS supports people’s health and well-being to ensure that they are able stay well and in good health for as long as possible.

“But we must recognise that overall more people are more are sick than they have been, and they have also have greater and more complex healthcare needs, so it is crucial the government starts treating investment in the NHS as an explicit tool of economic development and health improvement so that we can start to move the dial in driving down the stark and growing health inequalities present across our society.

“While there was much to welcome in this year’s GP contract the sad reality is the 1.9 per cent uplift for general practice is simply not enough, we now need to see a renewed and reinvigorated commitment to support primary care, including through additional multi-year investment and to build the strong primary care infrastructure needed to offer a greater range of services to patients fit for the future.”