21.09.15
Investment in general practice ‘marginal’ as salaries drop
Investment in general practice increased by less than 3% between 2013-14 and 2014-15, a report by the Health & Social Care Information Centre (HSCIC) found.
In 2014-15, the total spend on general practice, including the reimbursement of drugs dispensed in practices, was of £9m – marginally above the £8.76m spent in the previous financial year.
The findings come just a week after it was revealed that salaries for combined GPs working in either general or primary service practices fell for the fourth year in a row by almost 3%.
Dr Chaand Nagpaul, BMA GPs committee chair, said the “moderate rise” in investment combined with the progressive decline in income meant practices were “increasingly unable to cope with the financial strains facing them”.
He said expenses now amount to as much as two-thirds of an average practice’s income as GPs have to deal with rising costs for utilities, building upkeep and staffing.
“At the same time, many practices are struggling from a combination of rising patient demand, staff shortages and more care being moved into the community from hospitals,” he added.
Nagpaul noted that it was “unclear” was proportion of the increase in GP spend had gone into frontline services, if at all. He criticised the government for failing to adequately address the “unprecedented levels facing general practice”.
He added: “This report demonstrates that a limited amount of NHS resources are being spent on general practice at a time when workload pressures on GPs are rapidly rising.
“The limited rise in local funding is likely to be the result of the extra work done by practices on admission avoidance last year. Unfortunately, there is little evidence that this money will be recurrent and enable GP practices to invest in long-term frontline patient care.”
The committee chair called on politicians to address the “fundamental” long-term funding pressures facing general practice, which necessitate sustained investment in order to give services the resources they need.
NHS England chief executive Simon Stevens, in his speech to the NHS Expo earlier this month, acknowledged the relatively low amount of investment in primary care in recent years.
He said: “We know that the availability of investment in primary and community and social care has been squeezed relative to other parts of the system.”
He showed a slide with two contrasting figures: 0.8%, the real-terms drop in funding for general practitioner services “since the economic downturn”; and 12%, the real-terms rise in funding for “general acute secondary care services” in the same timeframe.
“It’s no great surprise that we see continuing pressure compounding into the hospital system, when you look at that disconnect in how we have used the resources at our disposal,” he told the conference.