Ministers must “radically” reform the way GP funding is allocated across the country because it results in the poorest areas receiving inadequate healthcare, family doctors have warned.
The Royal College of GPs (RCGP) wrote in an open letter that the Carr-Hill formula, which has been used to allocated core GP funding since 2004, is outdated as it does not equitably distribute funds and as a result has contributed to the widening of health inequalities across the country.
They said that the formula, which is used to determine how much money for each patient is allocated to each GP practice, does not adequately take into account deprivation levels of a local area. Previous studies had found that for every 10% increase in a practice’s deprivation level, payments only increased by 0.06%. Furthermore, GP practices in areas with the highest levels of deprivation have on average 300 more patients for each GP than those in more affluent areas.
The letter, with its co-signatories including the Health Foundation, the NHS Confederation’s Primary Care Network, and the charity National Voices, added 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 comes after previous analysis by the Guardian revealed that areas across England where the highest proportion of ethnic minorities live have the poorest access to GPs, with experts having attributed this disparity to the same outdated model being used to determine funding.
The RCGP called on the government for a “radical change” to general practice funding, to allow for funds to be channelled into areas of the greatest need and to “better take into account the needs of different communities”. They said this change was essential for tackling the current health disparities that exist across England.
Prof Kamila Hawthorne, the chair of the RCGP, said a review of the funding structures was essential for ensuring that “the communities worst affected by rising rates of deprivation get the support they need.
“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.”
She added: “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.”
Jacob Lant, the chief executive of National Voices, said it was clear that the GP practices working in the poorest areas “get less money and have fewer doctors”.
Lant said: “As a result, the patients they serve struggle to get the care they need, compounding the health inequalities they are already experiencing due to lower employment rates, poorer housing, and other factors.
He added: “The resourcing of GPs must be designed to properly reflect the needs of their local communities. This needs an overhaul of funding formulas and mechanisms to ensure the cashflows to where it is needed most and where it will help to narrow the huge gaps we see in healthy life expectancy in this country.”
A Department for Health and Social Care Spokesperson said: “By sticking with our plan for a faster, simpler, fairer healthcare system across the country, we are now delivering over 60 million more GP appointments per year, with over 39,000 additional staff covering a range of roles, including pharmacists, now working in general practice compared to 2019.
“NHS England is working to reduce health inequalities and improve the health of the poorest 20% of the population, regardless of where they live while our forthcoming Major Conditions Strategy will help address disparities in health outcomes, supporting the mission to improve healthy life expectancy by 2030.”
