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Analysis

Shortfalls of funding for general practice in deprived areas

Laura Castle, Melanie Bradshaw, Thomas Patel-Campbell, Michael Holmes and John McEvoy
British Journal of General Practice 2020; 70 (700): 559-560. DOI: https://doi.org/10.3399/bjgp20X713357
Laura Castle
Haxby Group, York & Hull.
Roles: Salaried GP
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Melanie Bradshaw
Haxby Group, York & Hull.
Roles: Head of Business Intelligence
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Thomas Patel-Campbell
Haxby Group, York & Hull.
Roles: GP Partner and Chief Clinical Information Officer
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Michael Holmes
York & Hull; Vice Chair (Membership), Royal College of General Practitioners.
Roles: GP Partner, Haxby Group
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John McEvoy
Haxby Group, York & Hull.
Roles: Managing Partner
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INTRODUCTION

In April 2019 the Haxby Group, through a contract tender process, acquired two surgeries in a deprived area of Hull, Yorkshire. These are specifically located in Calvert and Newington with approximately 10 000 patients. This, in addition to six sites in York and three other sites in Hull, with centralised administrative services, make up the Haxby Group. The transformative process that has followed has highlighted many positive outcomes from the use of at-scale general practice and diversifying the workforce but has become increasingly hindered by funding deficits. In particular the use of the Carr-Hill formula and Quality and Outcomes Framework (QOF)-driven payments negatively impact a practice’s ability to provide appropriate care in deprived populations.

The population served by this new contract is predominantly young (Figure 1). The area, like most of Hull, is especially high on the Index of Multiple Deprivation, scoring 43.7, compared with 28.1 at another Haxby practice in Hull and 10.4 in York. As is often seen in deprived areas, there is a high incidence of drug and alcohol misuse plus mental health problems. Alongside this, 9.0% of the patients are recorded with obesity and 55.9% as smokers. However, given the average age of the population, most chronic diseases have a prevalence below the clinical commissioning group (CCG) and national averages (Table 1).

Figure 1.

Patient age distribution in years of males (blue) and females (red) at Calvert and Newington in 2019.

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Table 1.

Comparison of prevalence data for major comorbidities in Calvert and Newington, nationally,8 …

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British Journal of General Practice: 70 (700)
British Journal of General Practice
Vol. 70, Issue 700
November 2020
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Shortfalls of funding for general practice in deprived areas
Laura Castle, Melanie Bradshaw, Thomas Patel-Campbell, Michael Holmes, John McEvoy
British Journal of General Practice 2020; 70 (700): 559-560. DOI: 10.3399/bjgp20X713357

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Shortfalls of funding for general practice in deprived areas
Laura Castle, Melanie Bradshaw, Thomas Patel-Campbell, Michael Holmes, John McEvoy
British Journal of General Practice 2020; 70 (700): 559-560. DOI: 10.3399/bjgp20X713357
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  • Article
    • INTRODUCTION
    • HEALTH INEQUALITY AND DEPRIVATION
    • WORKFORCE AND SYSTEM CHANGES
    • NEGATIVE IMPACTS OF FUNDING FORMULAS
    • NEED FOR RE-EVALUATION
    • Notes
    • REFERENCES
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More in this TOC Section

  • Focused action is required to protect ethnic minority populations from COVID-19 post-lockdown
  • The multimorbidity dead end: how we got here and possible ways out
  • Digital health in primary care: risks and recommendations
Show more Analysis

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