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Letters

It’s time to look again at GP funding

Sian Howell and Payam Torabi
British Journal of General Practice 2021; 71 (702): 12-13. DOI: https://doi.org/10.3399/bjgp21X714401
Sian Howell
Park Medical Centre, Southwark, London. Email:
Roles: Salaried GP
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  • For correspondence: sian.howell@nhs.net
Payam Torabi
Park Medical Centre, Southwark, London.
Roles: Salaried GP
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The COVID pandemic has shone a spotlight on long recognised inequalities in health outcomes,1 which have been widening in recent years.2 Castle et al3 describe how the general practice funding formula negatively impacts the ability of general practice teams to provide equitable care, with the risk of further widening these inequalities.

The Health Foundation’s recent report Level or Not?4 outlines the increased workload for practices serving our most deprived areas. It finds that, once adjustments are made for the associated increased workload in poorer areas, these practices receive 7% less funding per patient than those serving less deprived populations. Unsurprisingly, the report Who Gets In? finds that those living in the most deprived areas are less likely to report a positive experience of general practice care.5

Boomla and colleagues6 argued back in 2014 for a fairer distribution of funding to reflect the additional workload in deprived areas. Their data on consultation rates for those in the most and least deprived quintiles of multiple deprivation found vastly increased consultation rates in deprived areas. This reflected Marmot’s finding of an 18-year-gap difference in disability-free life expectancy,7 and highlighted the need to recognise the very tangible additional workload this brings to general practice teams.

The partnership model, which underpins general practice, involves a single funding stream for partners’ income and patient care. During times of significant challenges for the healthcare system, this can lead to stressful and impossible choices for those working in deprived areas with impacts on recruitment, investment into patient care, and the wellbeing of practice teams.8

We would argue that it is time to look again at general practice funding to better reflect the workload involved to meet patient need, and mitigate rather than exacerbate the wide health inequalities so worryingly highlighted in this current pandemic.

  • © British Journal of General Practice 2021

REFERENCES

  1. 1.↵
    1. Hart JT
    (1971) The inverse care law. Lancet 297, 7696, 405–412.
    OpenUrlCrossRefPubMed
  2. 2.↵
    1. Marmot M
    (2020) Health equity in England: the Marmot review 10 years on. BMJ 368, m693.
    OpenUrlFREE Full Text
  3. 3.↵
    1. Castle L,
    2. Bradshaw M,
    3. Patel-Campbell T,
    4. et al.
    (2020) Shortfalls of funding for general practice in deprived areas. Br J Gen Pract, DOI: https://doi.org/10.3399/bjgp20X713357.
  4. 4.↵
    1. Fisher R,
    2. Dunn P,
    3. Asaria M,
    4. Thorlby R
    (2020) Level or not? Comparing general practice in areas of high and low socioeconomic deprivation in England (Health Foundation, London) https://www.health.org.uk/publications/reports/level-or-not (accessed 8 Dec 2020).
  5. 5.↵
    1. Fisher R,
    2. Fraser C
    (2020) Who gets in? What does the 2020 GP patient survey tell us about access to general practice? (Health Foundation, London) https://www.health.org.uk/news-and-comment/charts-and-infographics/who-gets-in (accessed 8 Dec 2020).
  6. 6.↵
    1. Boomla K,
    2. Hull S,
    3. Robson J
    (2014) GP funding formula masks major inequalities for practices in deprived areas. BMJ 349, g7648.
    OpenUrlFREE Full Text
  7. 7.↵
    1. Michael M,
    2. Bell R
    (2012) Fair society, healthy lives. Public Health 126, Suppl 1, S4–S10.
    OpenUrlCrossRefPubMed
  8. 8.↵
    1. Jones R,
    2. Majeed A,
    3. Bhatti N,
    4. et al.
    (2015) Should general practice give up the independent contractor status? Br J Gen Pract, DOI: https://doi.org/10.3399/bjgp15X685441.
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British Journal of General Practice: 71 (702)
British Journal of General Practice
Vol. 71, Issue 702
January 2021
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It’s time to look again at GP funding
Sian Howell, Payam Torabi
British Journal of General Practice 2021; 71 (702): 12-13. DOI: 10.3399/bjgp21X714401

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It’s time to look again at GP funding
Sian Howell, Payam Torabi
British Journal of General Practice 2021; 71 (702): 12-13. DOI: 10.3399/bjgp21X714401
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