Implementing a new GP funding formula based on population need would cost just £333m in England, according to new modelling by two ICBs.
Leicester, Leicestershire and Rutland ICB and Frimley ICB came up with new formulas to redistribute GP funding to address inequalities in the existing primary care funding model.
The pilot run in Leicestershire – whereby the cost-of-staff element in the Carr-Hill formula calculation has been replaced with a needs-and-deprivation element – had been lauded in the Fuller stocktake, and now both ICBs said that they have been calling for a national solution to be implemented and funded by the Government.
Dr David Shepherd, a retired GP who led the project in Leicestershire, shared insights from the implementation during a webinar for GPs today, as well as calculations of how much a new formula could cost nationally.
He said: ‘I worked out that to level up all of our practice to the second best funded group in our practice population nationally, in England, would cost £333m right now.
‘When you consider that the Rwanda scheme was budgeted to cost £750m at least, it just shows if politicians want to do it, they can find the money. It’s affordable if you want to do it.’
In Leicestershire, the new GP funding model based on population need was awarded money to run this year, despite facing criticism from local GPs.
As part of the pilot, 127 practices across LLR were grouped into four categories from most to least underfunded, recognising that all practices in LLR feel underfunded.
The most underfunded half of practices were given a share of £2.85m from the ICB annually from April 2022, with £119,000 being the maximum amount a single practice received in 2024, to bring them up to the average level of funding for the patient needs at their practice.
Former director of primary care development for Frimley ICB Caroline Farrar said that despite the success of the pilot, there is a need for a new national formula to be implemented, rather than individual ICBs coming up with their own formulas.
She told the webinar: ‘I suppose what you might expect us to be doing is going around potentially 40 other systems trying to persuade people to do this.
‘But actually, although we’ve shown that it can be done with the tools now available I think we’ve come to the conclusion that we shouldn’t, and don’t want to do that, because even if we all have the will, momentum and the technical capability, there’s an enormous amount of complexity in amending a national formula.
‘There’s a growing consensus that we need to apply our collective expertise to achieve a national solution.’
Pulse had contacted the Department of Health and Social Care for comment.
It comes after the BMA’s GP committee called on the Government to replace ‘outdated funding formulae’ to accurately reflect the communities that practices care for, as part of its demands to end collective action.
And the RCGP also recently called on the Government to ‘radically’ reform the current Carr-Hill formula.
The current formula is supposed to ensure resources are directed to practices based on an estimate of their patient workload, taking into account ‘drivers of workload’ and ‘unavoidable costs’.
But the BMA has also argued for some time that the formula is outdated, and that the national GP practice contract baseline fund has been ‘eroded’ over the years.
Pulse recently revealed that NHS England is willing to revisit GMS global sum calculations, as long as GP practices agree to share their payroll data with commissioners.
A charge of £1 per consultation would more than cover the cost.
Good work Dr Shepherd.